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GOD IN DISEASE, 



MANIFESTATIONS OF DESIGN IN MORBID PHENOMENA. 



BY 

JAMES f! DUNCxyN, M. D., 

PHYSICIAN TO SIR P. DUN'S HOSPITAL, DUBLIN. 



--+-«♦-•-«►-»— 



• The works of the Lord are great, sought out of all them that have pleasure 
therein." 

; AVhoso is wise and will observe these things, even he shall understand the 
loving kindness of the Lord." 



PHILADELPHIA : 
LINDSAY & BLAKISTON. 

1852. 






Gift 

Mrs. Hennen Jennings 
April 26, 1*3B 



CRISSY & MARKLEY, PRINTERS, 

Goldsmith's Hall, Library Street, 






5 



CONTENTS. 



i <» • <► ► 



Page 
INTRODUCTION, V 

CHAPTER I. 

On disease as depending upon an active intelligent cause, 9 

CHAPTER II. 

On the nature of the design which disease is intended to 
accomplish, 34 

CHAPTER in. 

On the existence of disease in general as affording evi- 
dence of design, 49 

CHAPTER IV. 

On the varieties of disease as affording evidence of de- 
sign, . . . . • 67 

CHAPTER V. 

On the pain of disease as affording evidence of design, 84 

CHAPTER VI. 

On the modifications of pain as affording evidence of 
design, 102 



IV CONTENTS. 

Page 
CHAPTER VII. 

On some other symptoms of disease as affording evidence 
of design, 121 

CHAPTER VIII. 
On processes of preservation in disease, 140 

CHAPTER IX. 
On processes of reparation, . . 162 

CHAPTER X. 
On processes of adaptation, 177 

CHAPTER XL 

On the phenomena of disease as illustrating spiritual 
truths, 190 

CHAPTER XII. 

On the conduct of the physician as illustrating the deal- 
ings of God with His creatures, 210 

Conclusion, 223 



INTRODUCTION. 



The view of disease presented in the following 
pages is believed to be altogether original. Most 
persons are in the habit of admitting, that the 
visitation of sickness, is the result of the direct 
appointment of God ; but scarcely any one ap- 
pears to think that such an admission implies the 
existence of features stamped upon the dispensa- 
tion, similar to what are to be found in other 
parts of the Divine proceedings and that are 
eminently deserving of being studied carefully. 
The present work is intended to direct attention 
to the subject, and to unfold, by an analysis of 
the phenomena of disease, the evidence of design, 
contrivance, and beneficence, that lie scattered 
in profusion over every page of this volume of 
natural history. In executing his task, the author 
has not hesitated to avail himself of all the light 
that the progress of pathological science in recent 
times has placed at his command, while he has 
endeavoured to guard against introducing into his 
argument every thing that persons of the most 
fastidious taste can properly object to. He has 
also avoided, as far as possible, the use of techni- 
cal terms, so as to render the work easily intel- 
ligible to every class of ordinary readers. 
1* 



VI INTRODUCTION. 

In saying that the views here unfolded are 
original, it is not intended to be asserted that 
intelligent physicians, who are accustomed to 
observe the workings of the great first cause, in 
what is constantly passing before their eyes, may 
not have noticed many of the facts which are 
here presented to the reader. Isolated glimpses 
of the truth inculcated in these pages have un- 
doubtedly been often obtained, but disease as a 
whole, has never yet, so far as the author is aware, 
been considered in this light. 

Every attempt to investigate and explain the 
operations of God, when conducted in a right 
spirit, must be attended with advantage. Fami- 
liarity with his works and ways has a necessary 
tendency to expand and elevate the mind. The 
more thoroughly we become acquainted with his 
proceedings, the deeper will be our impression of 
His unchanging faithfulness, goodness, and truth. 
It is hoped that the present effort to explore a 
new region of the Divine proceedings, will be 
favourably received by every one who is capable 
of deriving enjoyment from such exalted subjects 
of contemplation. 

Nor is it merely in extending our knowledge of 
the works of God that the present publication is 
likely to be useful. It is believed that it may 
besides have a beneficial effect in correcting cer- 
tain erroneous opinions that prevail generally, and 
that exercise an injurious influence on the public 



INTRODUCTION. Vll 

mind. These errors arc principally two — the idea, 
that the visitation of sickness is a casual occur- 
rence ; and the idea, that it is a punishment 
specially inflicted for some previous misconduct. 
Whoever entertains the first of these opinions 
labours under a mistake, which necessarily pre- 
vents his deriving the slightest benefit from the 
affliction. Whoever, on the contrary, adopts 
the second — and this is the case frequently with 
persons who have been more than usually afflicted 
— falls into an error of an equally dangerous 
description : he not only loses the benefit that the 
visitation is calculated to produce, but also runs 
the risk of forming a wrong view of the character 
of God. Whenever a man is led to look upon 
an attack of illness as the result of a special 
providence directed against himself, in conse- 
quence of some offence he may have committed, 
his first step naturally is, to examine the records 
of memory, to see and discover the precise act for 
which the trial is sent. Should he fail in this, as 
happens not unfrequently, or should he select 
some circumstance in his past life which he sup- 
poses may be the cause of his misfortune, but 
which appears to his partial judgment to be alto- 
gether disproportioned to the severity of the 
sentence, his mind becomes unhinged, he im- 
peaches the justice of the divine dispensations, 
and murmurs at a trial, the precise nature of 
which he does not understand. Such a state of 



Vlll INTRODUCTION. 

mind is evidently unsuited to the position of a 
dependent creature. It places God at the bar of 
human reason, to take His trial for the propriety 
of His conduct. And it makes the limited and 
imperfect notions of man to be the judge of the 
designs and doings of the infinite and eternal God. 
It is to be feared that many real Christians, en- 
lightened upon other subjects, labour under this 
mistake, and so fail of deriving comfort and im- 
provement from the trials they are called upon to 
endure. A correct view of the nature of these 
dispensations would have a very different effect. 
The man who regards God as a father and not 
as a judge, and who looks upon his dealings as 
designed merely to chasten his creatures, will 
neither anxiously search for the particular sin that 
occasioned the infliction, nor question the wis- 
dom that appointed it. The full conviction that 
God has a wise and gracious purpose in all His 
appointments concerning us, will hush every mur- 
mur into silence, and will quicken the graces of 
faith and patience into increased activity. 

If this little work should be in any way instru- 
mental in correcting the least error upon this 
important subject, and in diffusing sounder views 
of the work and character of God, the author will 
feel himself abundantly rewarded for all the time 
and trouble bestowed upon its preparation, while 
the glory shall be given to Him who alone is the 
author and giver of every good and perfect gift. 



GOD IN DISEASE. 



CHAPTER I. 

OF DISEASE AS DEPENDING UPON AN ACTIVE 
INTELLIGENT CAUSE. 

There are three opinions entertained in the 
present day relative to the existence of disease in 
the world. The first, which is probably the most 
common, is, that it is a necessary condition of our 
present state of being, and that the circumstances 
which regulate its development in any particular 
instance, as well as the form it happens to assume, 
are altogether casual in their nature, and therefore 
undeserving of any serious consideration. 

The persons who entertain this opinion appear 
to have adopted it without ever having taken the 
trouble to examine the foundation upon which it 
rests, so as to have satisfied themselves of the 
accuracy of the conclusion at which they have 
arrived. It can scarcely be a matter of surprise 
if, under such circumstances, the opinion itself 



10 GOD, THE AUTHOR 

should turn out upon investigation to be entirely 
erroneous. 

The second opinion, though common enough at 
one period in the history of the world, is now 
almost completely exploded ; at least its advocates 
in the present day, if any exist, are extremely few. 
It is that which refers the visitation of sickness 
to the direct agency of the evil spirit. Many 
circumstances may be mentioned as helping to 
explain the change that has taken place in the 
public mind upon this point. In the first place, 
the general subject of Satanic influence, and of 
his immediate interference in the affairs of men, 
seems to be entirely discredited. It is not denied, 
in consequence of the statement of the Scriptures, 
that such an interference actually occurred in 
former ages ; but then it is contended that there 
were certain peculiarities in those times which do 
not now exist. Revelations from heaven were 
directly communicated to men, miracles were per- 
formed, and the manifestations of demoniac pos- 
session, whatever may have been its nature, were 
altogether different from any thing that occurs in 
the present day. The cessation of such phenomena 
justifies, it is believed, the idea, that there has been 
a total change in the government of the world in 
modern times, and that the power of wickedness 
has been controlled to an extent that was not for- 
merly the case. Whether this conclusion be really 



OF DISEASE. 11 

correct or not is a question, into the accuracy of 
which it is not necessary just now to enter. It is 
sufficient to remark that it appears to be generally 
entertained, and to involve, as a necessary conse- 
quence, the disbelief of Satanic influence being the 
cause of disease. In the second place, the enthusi- 
astic ardour with which experimental science has 
been prosecuted of late in all branches of natural 
philosophy — a fact that is at once the peculiar 
feature and the highest glory of the age — has had a 
necessary tendency to lead men to explain all the 
phenomena that come under their observation by 
the operation of natural causes, to the entire ex- 
clusion of those which are supernatural. And in 
the third place, the adoption of the hypothesis in 
question would involve the idea of a vast multi- 
tude of subordinate spiritual agents in active 
operation in the world, which the generality of 
men are not willing to admit without better evi- 
dence in its support than a mere assumption. For 
it is manifestly inconsistent with the notion of a 
single spirit, however rapid his movements may 
be, and however powerful his personal resources, 
to imagine that he can be at one and the same 
moment the immediate cause of such a variety of 
ailments as we know the human race is affected 
by, in such a multitude of places, unless he were 
possessed of the attribute of ubiquity, which we 
know is not the case. 



12 GOD, THE AUTHOR 

It cannot, however, be denied that the opinion, 
if held only by a few persons, has yet some show 
of plausibility for its support. The very nature 
of sickness, which is universally admitted to be 
an evil, and the suffering it induces, unless the 
result of a blind chance operating in the dark, 
and for no intelligible end, have something in 
themselves extremely characteristic of what might 
be supposed a 'priori to be the work of a malig- 
nant being. If an intelligent cause be admitted, 
it appears at first view inconsistent with the cha- 
racter of a being of infinite benevolence, such as 
God is, to suppose that he can be the author of so 
much suffering to His creatures. Besides, if we 
consult the sacred records on the subject, we shall 
find abundant evidence to prove that in several 
instances they speak of disease as having been 
actually produced in this way. Thus, not to speak 
of cases where it is said the individuals were 
possessed by demons, and which may be supposed 
to have had something miraculous in their na- 
ture, and so to bear no proper analogy to ordi- 
nary disease, we are told in Luke xiii. 16, of a 
daughter of Abraham who was bound by a spirit 
of infirmity, and whose illness was directly caused 
by Satan himself; and every reader of the Scrip- 
tures must be familiar with the case of Job, who 
was smitten in this way by an attack of sore boils. 
But even if it be admitted on the authority of 



OF DISEASE. 13 

these and other passages that disease is sometimes 
occasioned by the immediate intervention of the 
great enemy of mankind, it is important to observe 
that he is, even at such times, whilst gratifying 
his own malignant passions, subject to the control, 
and restrained by the power of the Great Supreme. 
From the case of Job, we are warranted in con- 
cluding that he can neither put forth his finger to 
touch a single individual, nor carry his malicious 
designs one step further than the divine persua- 
sion is pleased to allow. Viewed in this light, 
the intervention of Satan, if it really exist, cannot 
properly be regarded as the cause of the occur- 
rence of the disease, seeing that he is only an 
inferior instrument in carrying out the designs of 
Him who doeth according to His will in the 
armies of heaven, and among the inhabitants of 
the earth. 

This brings us, then, to the third opinion enter- 
tained upon this subject, and that is, that disease 
is really the result of the divine appointment in 
every instance where it occurs. This is distinctly 
stated in many passages of the sacred Scriptures. 
Thus it is said in 1 Chron. xxi. 14, the Lord sent 
pestilence upon Israel, and there fell of Israel 
70,000 men. In 2 Chron. xii. 15, we are told 
the Lord struck the child that Uriah's wife bare 
unto David, and it was very sick. In 2 Kings, 
xv. 5, the Lord smote King Azariah, so that he 
2 



14 GOD, THE AUTHOR 

was a leper unto the day of his death. In other 
passages a similar sentiment is conveyed, when it 
is stated that angels were sent for the express 
purpose of effecting the infliction. This opinion, it 
is scarcely necessary to mention, is maintained 
principally by persons who admit the truth of re- 
velation, and are in the habit of receiving implicitly 
every statement contained in the sacred pages. 

These three opinions, so different in them- 
selves, naturally exercise a very different in- 
fluence on the minds of those who embrace 
them. Men who hold the first view are not 
disposed to pay any particular attention to the 
visitation when it attacks them. A purely acci- 
dental circumstance can address itself neither to 
the understanding nor the affections. It can 
suggest no necessity for self-examination, no 
motive for caution, no stimulus to exertion. As- 
suming that there is the slightest benefit in sick- 
ness, it is obvious that the individual influenced 
by this view is incapable of profiting by it. So 
far as he is concerned, he is in the same condition 
after the attack as he was before. How are the 
advocates of the second opinion affected by it? 
Looking upon it as the infliction of a powerful 
and malignant being, they can only feel anger, 
hatred, and resentment ; they may be terrified by 
a sense of their being under the control of one 
whom they can neither see nor escape from, but 



OF DISEASE. 15 

it is impossible they can be humbled or improved 
by it. But when a man has been led by reading 
or reflection to embrace the third of these opi- 
nions, the result is altogether different. Though 
he may be overcome by the conviction of the 
power of the Being in whose hands he is, and 
though he may be smarting under the bitterness 
of the suffering he endures, yet the knowledge of 
the character of God, of his wisdom, goodness, 
and truth, is calculated to keep him from mur- 
muring under the dispensation, and to lead him to 
patience and submission. 

If this view of the subject be correct, it is 
evidently a matter of some importance that the 
opinion which is entertained in reference to it be 
correct: both that proper feelings may be pro- 
duced in the mind at the period of passing 
through the trial, and that the lasting benefit that 
sickness is intended to effect may be really accom- 
plished. For it will readily be admitted to be a 
double misfortune for a man to suffer all the 
inconveniences of sickness, and at the same time 
to lose, by his own carelessness or stupidity, the 
improvement it was designed to produce. 

It is proposed in the following pages to make 
a careful examination of the phenomena of disease, 
for the purpose of ascertaining how far it is of 
itself capable of solving the difficulty here sug- 
gested, and what amount of evidence, when fairly 



16 GOD, THE AUTHOR 

questioned, it is ready to bear as to the author 
of its arrangements. It is not unreasonable to 
suppose that, whatever be the source from which 
sickness proceeds, an examination conducted in 
this way will enable us to arrive at a clear and 
satisfactory conclusion; for there must, of neces- 
sity, be imprinted upon the phenomena that 
attend it infallible proofs of the origin from which 
it has proceeded. If disease be the result of pure 
accident, it will be characterized by the total 
absence of all method, contrivance, and design; 
for it is irrational to believe that any thing can 
follow from the blind operation of chance but 
irregularity and confusion. If, on the contrary, 
it be the work of an intelligent agent, it will 
exhibit those qualities in a degree of perfection 
proportioned to the intelligence possessed by Him 
who is the author of it. 

Such an examination, we have no hesitation in 
asserting, notwithstanding the apparent improba- 
bility of the opinion, will not fail to show that the 
visitation of sickness is really due to the direct 
appointment of God himself, and that not only is 
the ultimate design of the appointment full of 
benefit to the human race, but the various pro- 
visions that attend its progress are characterized 
by the kindest and most considerate regard to the 
circumstances in which they are placed. 

Perhaps it may be thought that such an inves- 



OF DISEASE. 17 

tigation as this is, is wholly unnecessary, inasmuch 
as it is quite possible for us to obtain all the 
information we require from a careful study of 
the sacred Scriptures alone, without a critical 
examination of what must be admitted to be a 
difficult subject to the generality of readers. 

In reply to such an objection, should it be 
started, it is sufficient to observe that, without at 
all undervaluing the authority and importance of 
testimony coming from such a source, the highest 
and most emphatic to which we can possibly refer 
in any controversy, it yet appears desirable, for 
many reasons, to pursue the subject in the manner 
here proposed. 

In the first place, there are many persons who 
are not in the habit of studying the records of 
inspiration with that care which is necessary to 
enable them to arrive at a correct conclusion upon 
the point, whose minds nevertheless require to 
be enlightened on the subject. Secondly; even 
admitting that the same conclusion can be equally 
well established by proofs drawn from distinct 
statements in the holy Scriptures, still it must be 
obvious that a new and independent mode of 
argument must tend materially to strengthen not 
only our conviction in the truth of the conclusion, 
but still more in the authenticity of that revelation 
that is thus proved to coincide with the well- 
observed facts of experience. And, lastly, the 
2* 



18 

circumstance that this study, interesting as it will 
be found to be, has not yet received that degree 
of attention which it is legitimately entitled to, is 
a sufficient reason for prosecuting the inquiry, 
even if other motives were wanted to induce us to 
enter upon it. 

Nor should the professional character of the 
details, to which it will be necessary to direct at- 
tention, be any reason to prevent general readers 
from giving it consideration. No fact will be 
stated, in the course of the argument, which per- 
sons of ordinary information in the present day 
may not fairly be presumed to be acquainted with ; 
and such explanations will be given, as we pro- 
ceed, as will render the various points easily in- 
telligible ; so that no difficulty in understanding 
the argument need be anticipated by any one; 
while sufficient care has been taken to exclude 
every thing from the body of the work, that per- 
sons of the most fastidious taste can object to. 

It is hardly necessary to remark, that the argu- 
ment employed in the present work — namely, 
that the discovery of a contrivance necessarily 
establishes the fact of the existence of an intelli- 
gent author to account for that contrivance — is 
the very same that has been used by previous 
writers to support the whole structure of natural 
theology, though the sources from which the argu- 
ment itself is drawn happen to be different. No 



OF DISEASE. 10 

philosopher that has yet treated of that subject 
lias drawn his statements from the field of sick- 
ness, simply for this reason — that the previous 
studies in which such persons happened to be en- 
gaged had not rendered them sufficiently familiar 
with the practical details of the subject to enable 
them to use the facts it exhibits in the prosecution 
of their enterprise. Hence the proofs of design 
in the history of disease, though numerous and 
striking enough when they come to be examined, 
have escaped the attention of those who might 
be supposed the most likely persons to have 
noticed them. 

Perhaps, too, another circumstance may be 
mentioned as helping to explain, in some measure, 
what some may be apt to consider an unaccount- 
able oversight on the part of those writers, and 
that is — that men do not usually go to look for a 
thing, unless in a place where they have a reason- 
able expectation of finding it. They may stumble 
upon it accidentally ; but they do not go out de- 
liberately to search for it, unless they have first 
had some reason to think that they will find it 
there. Now, in searching through the various 
departments of nature for proofs of design, it 
never occurred to men to look for it in disease, 
because they did not think that such a thing ex- 
isted in it. The structure of the globe, the me- 
chanism of the heavens, the anatomy of the body, 



20 

they regarded as the unmutilated work of the 
Great Architect of nature, and, therefore, they 
expected to find impressed upon them, in deep 
and lasting characters, the memorials of His 
handiwork. But disease they looked upon as the 
result of Adam's transgression — a casualty unex- 
pectedly introduced into the economy of the 
world, that defaced the beauty of the original 
proportions, and brought confusion and disorder 
into all the divine arrangements. Was it to be 
supposed that a catastrophe of this kind would 
exhibit any evidence of plan or purpose worthy of a 
moment's consideration? When a horde of barba- 
rians destroy a beautiful temple, do we expect to 
find any trace of care, of method, or arrange- 
ment, in the way in which they have effected 
their object? Are the marble pillars placed in 
some secure spot by themselves beyond the reach 
of injury? Is the ornamental cornice carefully 
packed up ? Are the massive stones, of which 
the building was constructed, laid by in such a 
way that they can be easily erected again without 
trouble and without loss ? No ; universal expe- 
rience tells us that such is not the way in which a 
ruthless enemy carries on the work of destruction. 
All the object he contemplates is, to effect his 
purpose as completely as possible, and in as short 
a time as he can. His desire is effectually to pre- 
vent the work being subsequently repaired or re- 



OF DISEASE. 21 

stored ; and hence he labours to mutilate as well 
as disarrange. 

Now let us for a moment suppose that in 
exploring some remote and uninhabited quarter 
of the globe, we were unexpectedly to come 
upon the remains of some gorgeous temple, 
which displayed the marks of great beauty in its 
original formation, but which had been levelled 
with the ground shortly after its completion, not 
by the action of the elements on its mouldering 
materials, nor by the ruthless hand of violence, 
but by a person of equal skill with its original 
architect, as evidenced by the care and attention 
bestowed in the position of the prostrate portions 
— would not the attentive observer be irresis- 
tibly led to the conclusion, that some circumstance 
having occurred to render the continuance of the 
edifice in the locality originally selected inexpe- 
dient, the owner of the building, or perhaps the 
architect himself, enamoured of his work, and un- 
willing that it should be destroyed, had superin- 
tended the process of taking it down, with the 
intention of rearing it again in a new and more 
permanent position. 

This is precisely the case in disease. Through- 
out every department of the various forms of 
physical suffering, there are to be found scattered 
in profusion the proofs of care, of tenderness, 
and of design. There is destruction, it is true, 



22 GOD, THE AUTHOR 

*but it is destruction carried on systematically by a 
friendly hand, not by a reckless adversary. Every 
thing connected with it tends to prove the truth 
of the inspired record, that it was not an unanti- 
cipated evil introduced into the world by the fall 
of Adam, but an event which had been foreseen 
from the first, and for whose occurrence provision 
had been made; so that what would, of itself, 
have proved only an unmitigated evil, has been 
overruled in such a way, that the curse has been 
converted into a blessing. 

If, then, the instances of divine wisdom and 
goodness which exist in disease have not hitherto 
attracted attention, it is not because they are few 
in number, or too deep to be easily discovered, 
but simply because they have not happened to be 
sought for. The whole fabric of natural theology 
can be as easily reared upon this department of 
nature as upon any other; and, in some respects 
it will be found that the facts it unfolds have 
peculiar advantages for the purpose. It may, per- 
haps, not be altogether out of place to glance 
briefly at the subject in this aspect, before proceed- 
ing further. 

The leading attributes of the Divine Being, 
presented to our notice in natural theology, are 
His power, wisdom, and goodness. It is easy 
to show that these can all be traced, with 
equal clearness, in disease; and first, as to His 



OF DISEASE. 23 

power. This is evidenced in the various changes 
of vital action that are continually induced for 
the purpose of bringing about recovery. What 
is there in the whole material universe that more 
strikingly conveys to our conceptions the idea of 
power than the simplest exercise of vital action? 
The force of gravity, as it is exerted in the amazing 
regions of space, may overwhelm our imagina- 
tion by the magnitude of the masses submitted 
to its control, as well as by the vastness of the 
distances at which it acts ; and the electric fluid, 
that sublime but mysterious agent, may produce 
a similar effect by the inconceivable rapidity of its 
motion, and by the resistless energy with which it 
accomplishes its terrific results; but the healing 
of an ulcer, and the crisis of a fever, when care- 
fully considered, will be found to contain as real 
and as incomprehensible, though certainly not as 
striking, an exhibition of the principle of power 
as either of the forces we have named. The 
reason is obvious. The manifestation of the latter 
depends upon the existence of life, every thing 
connected with which is mysteriously incompre- 
hensible. So long as vitality continues in any 
body, so long is that body capable of resisting, 
more or less effectually, the ordinary laws of 
chemical action, and even of physical influences. 
So soon as that principle is destroyed, these laws, 
previously held in abeyance, assume their supre- 



24 GOD, THE AUTHOR 

macy, and produce their customary effects. The 
decomposition of dead animal or vegetable matter 
is but the result of the assertion of those powers 
which were previously restrained by the energy of 
the living principle. This principle man is incapa- 
ble of calling into being. He can no more confer 
life upon brute matter, than he can create a new 
molecule, or confer upon what already exists a 
new property that it did not previously possess. 
In this, then, we see strikingly displayed the weak- 
ness of man and the power of Grod. Nor is this 
the only inference we are warranted to draw as 
to the character of God, from the instances to 
w T hich allusion has been made. If the healing of 
an ulcer is a proof of His power, from the fact 
that it depends upon a new direction being given 
to the vital forces, it is equally a proof of His 
wisdom and His goodness ; because the fact itself 
establishes the purpose, for which that power has 
*Jbeen exerted, to be one of pure benevolence, 
guided and directed by appropriate skill. There 
can be no mistake here. If the fact of the oc- 
currence of the change in the living energy of the 
animal frame, at such a time, be established — and 
its reality is proved by the unanimous testimony 
of all medical men — it necessarily leads to the con- 
clusion, that the Being who appoints that change, 
and superintends and controls its occurrence, must 
be possessed, not only of goodness to suggest such 



OF DISEASE. 25 

a course, but of wisdom to plan and arrange its 
proceedings, and of power to effect its accom- 
plishment. But, not to insist too strongly upon 
this argument, we may observe, generally, that 
wherever contrivance is found to exist — distinct 
elaborate contrivance, by which we are to under- 
stand the arrangement of several provisions to the 
accomplishment of a single purpose — we are jus- 
tified in concluding that the author of that con- 
trivance must be possessed of intelligence, espe- 
cially if the purpose for which the contrivance was 
framed be a desirable one, and the details of its 
provisions be characterized by suitableness, sim- 
plicity, and effectiveness* This is emphatically 
the case in disease, as will be clearly established 
in the subsequent chapters of this work. It would 
be out of place to attempt, at present, to adduce 
any evidence in support of the position, which will 
be abundantly evident as we proceed. 

Still further we are justified in concluding that 
the attribute of goodness characterizes every in- 
telligent being, in whose works we are able to 
discover the evidences of considerate care to pro- 
vide for the anticipated necessities of others, and 
to guard against contingent evils, to which they 
may happen to be exposed. When, in fact, the 
comfort and happiness of creatures capable of 
enjoyment have been made the objects of his direct 
and judicious attention. This can be easily shown 
3 



26 GOD, THE AUTHOR 

as regards many of the arrangements "of sickness. 
A reference to the eighth chapter will satisfy every 
candid mind of the existence of benevolent fore- 
thought on the part of the Author of the dispen- 
sation, in appointing certain processes to be set 
up in particular cases, to check the progress of 
destruction, and to guard against accidental con- 
sequences of the greatest danger. Can any thing 
more strikingly prove the goodness of the agent, 
who directs and superintends the arrangement of 
the appointment, than this? He permits just so 
much to happen of an unpleasant nature as He sees 
to be absolutely necessary for the accomplishment 
of His own wise purposes ; but He takes especial 
> care to prevent the painful process going one step 
further, or being carried one degree deeper, than 
that necessity absolutely requires. 

And not only are those attributes, of which we 
have spoken, clearly manifested in the arrange- 
ments of sickness, but what may be considered 
the higher and more glorious perfections of the 
divine character can be traced with equal ease. 
Such, for instance, as the faithfulness, justice, 
holiness, and mercy of God. The divine faith- 
fulness is proved, in natural theology, by the 
uniformity with which the physical phenomena of 
the material universe take place. The motions 
of the planets in their courses, the phases of the 
moon's disc, the regularity of the seasons, all 



OF DISEASE. 27 

establish this truth in a striking manner. A proof, 
similar in its kind, and equally convincing, is 
afforded by disease. Morbid phenomena pursue 
their course with equal regularity. They have 
their periods of invasion, of maturation, and de- 
cline. Their progress is capable of being ascer- 
tained, and made the subject of calculation; and 
not only so, but the action of remedies upon the 
human frame exhibits a similar uniformity. All our 
systems of medicine, whether correct or erroneous, 
are evidently founded upon this hypothesis. Were 
these principles not admitted, there could be no 
such thing in practice as a rational plan of treat- 
ment. If the course of pneumonia were different 
to-day from what it was yesterday, and what it may 
be to-morrow ; if rhubarb were to produce a dif- 
ferent effect on the living organism at each time 
of its administration, the whole science of medicine 
would be reduced to a sea of endless uncertainties. 
It would, in that case, be impossible to anticipate 
what would probably occur in any particular in- 
stance, or what would be the effect that any remedy 
we might resort to would be likely to produce. 
The experience of previous cases would be no 
guide for future practice. Happily for mankind, 
things have been differently ordered. Owing to 
the regularity with which morbid processes occur, 
we are enabled to study disease with advantage, 
and to calculate with a warrantable amount of 



28 GOD, THE AUTHOR 

confidence, the probable effects of particular me- 
dicines in ascertained circumstances. It is true 
that we do not observe an absolute and mathe- 
matical accuracy in the course with which expected 
effects follow from particular remedies. Devia- 
tions undoubtedly occur from time to time, of a 
most embarrassing and unexpected nature. But 
the same thing happens also in the material world. 
No two successive seasons are exactly alike, and 
the movements of the planets are marked by 
occasional irregularity; but the causes of these 
deviations are capable of being ascertained and 
accounted for, as has been recently exemplified 
in the discovery of the new planet, Neptune. And 
so in disease, the causes of these abnormal results 
are to be sought for in a deeper study of the modi- 
fying influences that control the natural and ordi- 
nary action of the remedies in question. 

Justice is an attribute which has reference to a 
law of some kind or other, and which implies the 
existence of a relation between moral agents of 
different classes. One is the lawgiver ; the other 
is the person subject to that law. Justice requires 
that the lawgiver shall, in all cases, act in con- 
formity with the requirements of the law, vindicate 
its authority, and punish the offender. Man — not 
to speak of any higher kind of law — is placed 
naturally under the law of personal exertion ; the 
justice of God requires that this law should be up- 



OF DISEASE. 29 

held, and that every violation of its requirements 
should be punished with an appropriate penalty. 
This law clearly exists, and every one must be 
aware that its sanctions are enforced in the poverty 
that oppresses some, and the misery that attends 
others, who transgress its enactments. But the jus- 
tice of God, as thus established, is not more clear or 
more convincing than it is when the proof is drawn 
from the history of disease. In reference to health, 
man is equally placed under a law. We have the 
laws of temperance, of cleanliness, of exercise, any 
one of which, when violated, brings down upon 
the offender, as a necessary consequence, a more 
or less distinct punishment for his misconduct. In 
some respects, the impression of this truth — that 
the Divine Being is invested with the attribute of 
justice, and that He will not allow any of His laws 
to be violated with impunity — is more striking 
when conveyed to the mind by disease, than when 
it is inferred by a consideration of ordinary pro- 
vidence. For the artificial state of society that 
prevails in all civilized communities, obscures, to 
a very great degree, in the public mind, the sense 
of personal exertion, which is the lot of all men ; 
and it is needless to observe, that wherever this 
condition is not recognised, it is impossible for the 
punishment, which is the necessary consequence of 
the violation of the law, to be clearly appreciated. 
Then, again, as to the holiness of God. 
3* 



30 GOD, THE AUTHOR 

Some persons may imagine that this attribute is 
identical with justice; but it is really different. 
Holiness has reference to the abstract principles 
of right and wrong, whether embodied in legal 
enactments or not. Justice always refers to a 
law ; but the law itself may not be a righteous 
one : it may be very much the reverse. When 
ever this is the case strict justice would require 
the lawgiver to pronounce sentence in opposition 
to the clear requirements of abstract holiness. 
The holiness of God is proved by the existence of 
natural conscience in every man, which leads him 
to discriminate between right and wrong, and 
which punishes him by the sting of remorse 
whenever he disobeys its suggestions. Nor is 
the testimony of disease wanting to prove the 
existence of this attribute in the divine character. 
Many of the maladies with which men are afflicted 
are the direct and admitted result of their own 
previous misconduct — misconduct, which the in- 
ternal monitor clearly and emphatically con- 
demns. Does not this fact show that He, who 
is the author of the link that binds the conse- 
quence to its cause, is a God of holiness, and 
that He disapproves of the course of action that 
necessarily leads to such a result ? 

We come now to speak of the attribute of mercy ; 
and, in doing so, we cannot fail to be struck with 
the superior advantages possessed by disease for 



OF DISEASE. 31 

unfolding it over every other department of na- 
ture to which our attention may be directed. 
Many persons are impressed with the idea that 
goodness and mercy are identical, and that any 
thing which proves the existence of one of these 
attributes necessarily establishes the other. But, 
though closely connected, there is a wide and 
obvious distinction between them. Goodness is 
indiscriminating in its operations : it delights to 
scatter the blessings it possesses indifferently 
upon all around. The objects upon whom it 
lavishes its bounty may or may not be in a 
condition to require the benefits it bestows ; 
they may be rich, comfortable, and happy, just 
as readily as poor, miserable, and in want. 
Mercy, on the other hand, is goodness specially 
directed for the relief of the necessitous. It 
selects the objects of its compassion on the 
express grounds of their requiring its assistance, 
and it suits the relief it ministers to the exact 
circumstances of the sufferers. It is this dis- 
criminating and adapting tendency that consti- 
tutes the entire difference between goodness and 
mercy. Let us illustrate the statement by an 
example. The unfallen angels that encircle the 
throne of the Eternal continually experience the 
full measure of the divine goodness ; but they 
are incapable of being in any sense the objects 
of the divine mercy. The inconceivable blessed- 



32 GOD, THE AUTHOR 

ness of their condition is no impediment to their 
enjoyment of the one ; but it is a perpetual 
bar to their reception of the other. With man, 
on the contrary, the case is different : he may be, 
and he is, at one and the same moment, the 
unworthy object of both. The wretchedness of 
condition that he inherits from his first father, 
while it emphatically renders him a suitable sub- 
ject for the one, in no degree renders him un- 
fitted for the blessings of the other. It is only in 
the reflected experience of the human race that 
angels can discover the slightest trace of the 
existence of that attribute, which is the culmina- 
ting point of the divine perfections. 

It may be questioned whether there is any 
thing in the ordinary course of nature that suit- 
ably illustrates and establishes this marvelous 
feature in the character of Grod. Distinctions 
are not drawn between one man and another 
by mere physical phenomena. The fields of the 
rich, equally with those of the poor, are watered 
by the fertilizing shower, or parched up by the 
scorching drought. The fury of the tempest 
strikes an indiscriminating blow on all within 
the reach of its violence. We discover in these 
arrangements no special exemption for any class 
or person, no peculiar provision for any of the 
children of sorrow. But when we come to ex- 
amine the details of sickness, the case is totally 



OF DISEASE. 33 

different. There we discover special provisions 
for allaying pain, for restoring health, and for 
rendering ailments, which are necessarily incur- 
able, to a certain degree more compatible with 
the comfort and activity of the invalid. Is 
not this mercy properly so called ? Is it not 
goodness specially directed to the sufferer ? Is 
it not discriminating in its compassion, and does 
it not adapt the peculiar benefits it dispenses to 
the exact necessities of the object it designs to 
relieve? The provisions of which we speak do- 
not exist except where their assistance is re- 
quired ; but no sooner do the circumstances occur 
which render them desirable, than we find them 
developed ; proving beyond all question the reality 
of the existence of this attribute, and of its active 
exercise. 

Who that considers these things can for a 
moment hesitate to admit that the author of 
sickness is really the same great being, who is 
revealed in the pages of inspiration ? His essen- 
tial attributes are the same, and His dealings with 
His creatures the same. If a person familiar with 
the works of art can pronounce without risk of 
error, from the mere consideration of an artist's 
style, the name of the person whose work he has 
examined, surely we are warranted in drawing a 
similar conclusion from an equally plain and 
striking analogy in the case before us. 



34 THE DESIGN 



CHAPTER II. 

OF THE NATURE OF THE DESIGN THAT DISEASE IS 
INTENDED TO ACCOMPLISH. 

It will scarcely be denied by any one who 
admits the existence of one supreme God, that 
the world, as it exists, is His work, and that 
nothing can happen in the arrangements of nature 
without his knowledge and permission. How far 
He is pleased to interfere in the direct manage- 
ment of human affairs may, perhaps, be questioned 
by some; but every one will admit that He is 
acquainted with every thing that occurs, and that 
He could prevent any thing from happening were 
He disposed to do so. This being the case, it 
may fairly be inferred that the very fact of disease 
existing is a sufficient proof that there are wise 
and satisfactory reasons for permitting its con- 
tinuance. It would be a direct charge of imper- 
fection against God, to suppose that He would 
allow things to happen by mere chance, or that 
He would remain an indifferent spectator of any 
thing that seriously affected the comfort and 
well-being of his dependent creatures. It is just 
as necessary, for the perfection of the divine 
character, that there should be wise and sufficient 



OF DISEASE. 35 

reasons for every thing He permits, as it is that 
there should be wise and sufficient reasons for 
every thing He does. This consideration, even 
though we might not be able to discover on the 
closest investigation any of those reasons that 
influence the divine mind, ought to be sufficient 
to satisfy us that such reasons exist, and that 
some good and benevolent purpose is really 
answered by the appointment. But it is well for 
us to know that we are not left wholly in the 
dark upon this important subject. A little 
examination is all that is necessary to enable us 
to discover some of the important purposes that 
disease is intended to serve in relation to man, 
though it is exceedingly probable that we may 
not be able to discover them all. If we are 
correct in the assumption that God is really the 
author of disease, it is not asserting too much to 
say that His design in the appointment is not 
single, but manifold. We know that in other 
instances He delights to make the same instru- 
mentality accomplish many useful ends ; and it is 
reasonable to suppose, on the principle of analogy, 
that the same thing holds true in the case before 
us. And if we shall be able to trace more than 
one useful end fulfilled by the visitation of sick- 
ness, we shall have our conviction strengthened 
in the accuracy of the opinion that it is due to 
God himself, while we shall have reason to admire 



36 THE DESIGN 

the ■wisdom that is thus manifested in making 
it subservient to several ends at one and the same 
time. 

We have already hinted at one useful purpose 
that it may be applied to, and which it was, 
doubtless, designed to accomplish, and that is, its 
giving us an insight into the divine character, and 
its unfolding to the intelligent eye some of His 
attributes, and their perfections. This, though 
an important benefit in itself, scarcely seems to be 
the main reason for the appointment. The same 
may be said of two other ends which have yet 
to be discussed; namely, its use in illustrating 
spiritual truths, and in exemplifying the manner 
of God's dealing with His intelligent creatures. 
But the case is different when we consider that 
every attack of illness is a standing memorial of 
our mortal condition, and a warning to prepare 
for the great change that awaits us. Every man 
must be satisfied in his own mind that, in confor- 
mity with the general law of nature, he must 
sooner or later leave the present sphere of 
existence. Every man who believes in the 
immortality of the soul must be convinced that 
the great business of life, when properly under- 
stood, is to prepare for the future state of being 
that awaits him. Every one who reflects upon 
the paramount importance of that future state, 
must feel that in comparison with it all present 



OF DISEASE. 37 

things sink into the shade and lose their value. 
Here, then, we have an end infinitely worthy of 
the great Author of the appointment, and sufficient 
in itself to account for all the difficulties that 
appear to encompass it. Trying as the visitation 
may be, yet if it serves to fasten attention upon 
.ruths of eternal interest, and to wean the 
affections from present and perishable things, it 
accomplishes an object more than enough to 
counterbalance all the inconveniences that attend 
the process. 

Before proceeding to consider the suitableness 
of the appointment for the accomplishment of this 
object, it appears to be necessary to say a word 
or two in reference to another object which is 
supposed by many persons to be one reason at 
least for which the visitation of disease is per- 
mitted to take place, and that is, that it is a 
punishment inflicted on the individual for some 
sin of which he has been guilty. This opinion 
has been held in all ages of the world. We find 
traces of its existence in the writings of the 
ancient Heathens ; and the question that the 
disciples put to the Saviour when they asked, 
" Lord, who did sin, this man or his parents, that 
he was born blind ?" proves that it was commonly 
entertained by the Jews. Nor is it altogether 
destitute of foundation. In the first place, many 
of the ailments we suffer from, as has already 
4 



38 THE DESIGN 

been remarked, are undoubtedly occasioned by 
our own misconduct. Secondly, we have the 
highest authority for saying that disease was 
unknown in the world before the fall of Adam. 
And, thirdly, the sacred Scriptures inform us of 
several instances where disease and pestilence 
were plainly inflicted upon men in consequence of 
some offence which they had committed. Thus, 
the Philistines were smitten with emerods because 
of their treatment of the ark (1 Sam. v. 6.) ; the 
Israelites died of a plague, when David imprudent- 
ly ordered a census to be taken (2 Sam. xxiv. 15) ; 
Azariah was struck with leprosy for profanity (2 
Kings xv. 5), and Gehazi for covetousness and 
falsehood (2 Kings v. 27). 

Before considering these arguments in detail, 
it is necessary to make a few remarks on the 
nature of punishment. In ordinary language, this 
word and correction are confounded together. 
Yet the ideas they represent are perfectly distinct. 
Punishment has reference to the past conduct of 
the criminal — correction to his future improve- 
ment. Punishment is a kind of revenge for 
offences already committed — correction, a kind 
of discipline to guard against their commission in 
future. Punishment is directed against the indi- 
vidual who commits the act — correction, against 
the act committed. Punishment includes the 
idea of displeasure on the part of the person who 



OF DISEASE. 39 

inflicts it — correction, on the contrary, that of the 
most tender solicitude for the welfare of him who 
is corrected. The design of punishment is solely 
to benefit society, that others may be deterred 
from the violation of the laws ; that of correction 
includes, in addition, the benefit of the individual, 
that he may become a better subject for the time 
to come. Keeping this distinction in mind, it may 
fairly be asserted that God never sends sickness 
as a punishment, but always as a correction. 

Let us now return to a consideration of the 
arguments already adduced in support of the 
contrary opinion. The first is founded on those 
cases of sickness that result from the misconduct 
of the individual. But even this circumstance 
is not inconsistent with the idea, that the design 
of the infliction is salutary, and not penal. There 
can be no correction without some sort of refer- 
ence to previous conduct. There must have been 
an offence committed ; that offence must be marked 
out in a sufficiently express manner to intimate dis- 
approbation. This can only be done by securing an 
obvious connexion between the two events — the 
evil and the consequence to which it leads. But 
the connexion, when it exists, does not by any 
means prove that the consequence partakes in any 
measure of the nature of punishment. Besides 
there are many cases — indeed we may say the 
great majority — of sickness in which we search 



40 THE DESIGN 

for such a connexion in vain. No previous 
misconduct can be detected to explain or justify 
the visitation. Many of the most amiable cha- 
racters are the most afflicted of the race. Many, 
on the contrary, of the most abandoned, who 
have tried the strength of their constitution by a 
long course of dissipation, enjoy uninterrupted 
health. Often the ravages of disease set in in 
infancy before the individual has become an 
accountable agent, and before conscious intelli- 
gence has asserted its dominion. How is it 
possible to reconcile these occurrences with the 
idea of punishment ? 

The second argument rests upon the fact, that 
disease did not occur in the world until after the 
fall of Adam, and it infers from this circumstance 
that it must be viewed as the penal consequence 
of his transgression. This is supported by the 
consideration that in every place exempt from 
sin disease is absent. There was none in Paradise 
before the fall. We are assured there will be 
none hereafter among the redeemed inhabitants 
of heaven. Its occurrence upon earth is entirely 
to be ascribed to the deep depravity of the human 
race. All this is most certainly true; but the 
question to be determined is this: is it true 
in the higher sense of an abstract punishment, 
or in the subordinate sense of a mere correc- 
tion ? Now it is important to notice, that if 



OF DISEASE. 41 

there were any vis consequentice in the argument, 
as put forward, it would follow that wherever sin 
can be discovered, there, as a matter of course, 
disease would prevail. But this is not the case. 
In the dark dungeons of despair there will be 
abundance of evil, but we have no warrant from 
the sacred Scriptures for inferring that there will 
be any sickness. It is impossible for unrenewed 
spirits to exist without committing sin. Their 
prolonged existence will only be one continued 
act of rebellion against God, and of malignant 
hostility against each other. Now, if it be cor- 
rect to regard sickness as a punishment, where 
would be the consistency of excluding it from 
that place which is emphatically devoted to pun- 
ishment — where the unmitigated wrath of God, 
in all its intensity, is poured forth upon the 
miserable inhabitants ? Would it not be a strange 
distinction to subject them to punishment of in- 
conceivable severity, and to spare them others that 
are comparatively trifling ? But if, on the contrary, 
it be intended for correction, we can perceive good 
and sufficient reasons for the difference. Within 
the walls of that prison-house there will be no 
improvement. It is written, " He that is then 
filthy shall be filthy still." And if this be so, 
where would be the propriety of using the rod of 
correction when there shall be no hope of refor- 
mation ? It is only in the present life that man 
4* 



42 THE DESIGN 

is in a state of probation — it is only in the present 
life that man is capable of undergoing discipline. 
Are we not warranted then in concluding, that what 
is so admirably fitted to effect this object, and 
which is to be found only in circumstances where 
this object can be effected, is really designed and 
intended for the accomplishment of the very pur- 
pose for which it is adapted ? Then, as to those 
cases mentioned in the Bible, where the infliction 
of disease was the immediate consequence of 
some offence, which is plainly specified, it is right 
to observe, that there is nothing in the history of 
those cases to lead us to infer that the judgment 
was sent as a punishment, and not as a correction. 
It is true that, as regards the Philistines, we have 
no reason for supposing that they derived any 
advantage from it : their wicked character would 
lead us to suppose them unfit objects of the 
divine mercy. But the question is not what the 
effects produced may have been, but what the 
purpose of the appointment actually was. In 
the case of Azariah and Gehazi it would be 
unwarrantable to imagine that the affliction had no 
good effect ; indeed, from Azariah's previous cha- 
racter, we have the best grounds for hoping that 
the visitation was a merciful one, and productive 
of the very best results. Even if it were to be 
admitted that disease, when sent to the wicked, 
was intended as punishment, it will by no 



OF DISEASE. 43 

means follow that it possesses this character 
when sent to the Christian; because many pas- 
sages of the Bible can be adduced which oppose 
such an idea in the plainest terms. For example, 
the reply of our Lord to that question, which has 
been already quoted, is sufficient to set the 
matter at rest. He says, " Neither hath this man 
sinned nor his parents, but that the works of 
God should be made manifest in him." — John ix. 3. 
Again, speaking of the sickness of Lazarus, he 
says, " This sickness is not unto death, but for 
the glory of God." — John xi. 4. Abijah, the son 
of Jeroboam, when a young man, was attacked 
with a fatal illness, and yet we are assured that 
the affliction was sent to him because he was the 
only member of the family in whom there was 
some good thing towards the Lord God of Israel. — 
1 Kings xiv. 13. The whole history of Job proves 
that he was not afflicted, as his friends ignorantly 
supposed, for his guilty hypocrisy, but for the 
purpose of glorifying God by his patience, meek- 
ness, and integrity. 

These instances are most important and in- 
structive. They teach us that, in the case of the 
Lord's children, sickness is often sent under cir- 
cumstances which do not warrant the idea, that 
the dispensation partakes even of the nature of 
chastisement, much less of punishment. It is not 
caused in any measure by their misconduct. It 



44 THE DESIGN 

is entirely the result of God's gracious purposes 
towards them. Having implanted in their souls 
the blessed fruits of the Holy Spirit, in all 
Christian graces and virtues, it is necessary, for 
his glory and for their benefit, that these should 
be exercised, strengthened, and increased. It is 
only the furnace of affliction, in some form or 
other, that can effectually develope these results ; 
and we may rest assured that when He selects 
bodily suffering as the form of affliction best 
adapted for any particular individual, He has 
wise reasons for the appointment, though they 
may be undiscovered at the time. 

But even to the ungodly, to the careless and 
impenitent, strange as the assertion may appear 
to some, these visitations partake of the nature 
of discipline, and not of punishment. The ex- 
pressions contained in the sacred Scriptures — 
"Ephraim is joined to his idols, let him alone." 
(Hos. iv. 17) ; and "Why should ye be stricken 
any more, ye will revolt more and more." (Isa. 
i. 5) — plainly prove that the purpose for which 
the judgments had been sent was, to lead the 
people from their sinful courses, and not to 
punish them for having originally entered on 
them. The argument of the prophets in each 
case would be inconsistent under any other hypo- 
thesis. The punishment of the sinner is reserved 
for a future state, when, without doubt, a just and 



OF DISEASE. 45 

holy God will not suffer him to escape ; but in 
the present life he is experiencing only long- 
suffering forbearance at his hands, and in so far as 
he neglects or despises it he is adding to his con- 
demnation. Nor is it any answer to this view 
to say, that the Bible represents God as being 
"angry with the wicked everyday." — Ps. vii. 2. 
Undoubtedly He is so ; but the way in which He is 
pleased to exhibit His displeasure is, not in send- 
ing sickness upon sickness, and affliction after 
affliction, but in a manner the very reverse — in 
permitting them to enjoy health and prosperity. 
Infatuated by these He leaves them to their own 
devices ; and their destruction is the consequence. 
The seventy-third Psalm clearly proves this. The 
Psalmist's mind had been sorely tried by the 
number and variety of his afflictions, compared to 
those of the wicked men he saw around him. He 
was at first disposed to regard these personal trials 
as evidences of the Lord's displeasure, and under 
this impression fell into a state of despondency. 
As soon, however, as he was enabled to take a 
correct view of the whole subject, he clearly saw 
the danger in which the wicked were placed by 
those very blessings, on account of which he was 
at first disposed to envy them. 

Our attention has hitherto been confined to the 
statements of the sacred Scriptures bearing on 
this subject, because they are both the most un- 



46 THE DESIGN 

erring and the most authoritative standard to 
which we can appeal for information. But a care- 
ful consideration of the facts contained in the 
subsequent pages will necessarily lead to a similar 
conclusion. If it be true that merciful provisions 
exist in disease, to mitigate its severity and to 
diminish its destructiveness, we have, in this fact 
alone, ample testimony as to the purpose in the 
divine economy it is designed to serve. In every 
kind of punishment, properly so called, we see 
inexorable justice rigidly exacting the full amount 
of the prescribed penalty, without the slightest 
regard to the sufferings of the victim, or the con- 
sequences which it occasions. In the administra- 
tion of discipline, on the contrary, we see justice 
tempered with mercy, listening to its suggestions, 
and yielding to its entreaties. While the majesty 
of the violated law is vindicated with becoming 
firmness, the utmost tenderness is exhibited to the 
unhappy culprit, and no unnecessary severity is re- 
sorted to, but such as is absolutely essential for the 
object it has in view, namely, the reformation of 
his character. All the improvements which have 
taken place of late years in the prison discipline 
of these countries — for which we are indebted to 
the philanthropic labours of Howard, Fry, Buxton, 
and others — proceed upon the assumption, that the 
principal purpose for which such places are main- 
tained is the correction of offenders ; and, so far 



OF DISEASE. 47 

as they keep this object in view, they approach in 
character to the benignant administration of the 
divine government. Nor is it any objection to the 
sentiment here advocated to say, that if the 
gracious Author of nature formed such a design in 
the appointment of sickness, that His intentions 
are more frequently frustrated than carried into 
effect — that men are seldom benefited by such 
attacks, though they are often hardened. It is 
one thing to say that a machine is adapted for a 
particular purpose, it is quite a different thing to 
take and apply it to that purpose. The mechanism 
of a watch may be admirably suited for keeping 
time, but if it be not wound up and set a-going, it 
will no more keep time than any shapeless mass of 
matter of the same size we may happen to lay our 
hands on. If it be set a-going and not properly 
regulated, every occasion we consult the dial it 
will lead us into error instead of giving us correct 
information as to the hour of the day. The mis- 
takes to which we formerly alluded may be ren- 
dered intelligible by this illustration. The fault 
that sickness does not produce salutary impressions 
upon those who suffer from it, lies, not in its un- 
suitableness to this end, but in its non-application 
on the part of those who regard it as a casual 
occurrence, and in the perverted use of it on the 
part of those who consider it a punishment and an 
expression of God's anger because of their guilt. 



48 THE DESIGN OF DISEASE. 

We have dwelt upon this subject at some length, 
because it is a matter of great importance to have 
right views in reference to it, and because we are 
persuaded, from personal observation, that the 
error in question prevails to a much greater extent 
than is generally supposed. Nor is it confined to 
persons ill-informed on other religious subjects. 
It exists among many of whom there is good reason 
for believing that they are Christians indeed. So 
long as it continues there can be no real enjoy- 
ment in spiritual things, and very little benefit 
from affliction. The mind, instead of being drawn 
to the Lord in meek submission to His will, is 
occupied about itself in endeavouring to discover 
the secret cause of the trial, and whether it succeed 
or fail, the result is equally unhappy. Disputing 
wiUh God about the justness of His dealings 
towards us, is not the way to derive advantage 
from His dispensations. The spirit must be hum- 
bled in order to be sanctified. It may not be easy 
to discover the reasons for the Lord's conduct 
towards His people in every instance ; but we may 
be assured of this, that there is not one drop of 
anger in the cup he gives them to drink, however 
bitter it may be to the taste ; and the conviction 
of His unchanging and eternal love, may well 
sustain and cheer them under all the circumstances 
of sorrow and of trial they may be called upon to 
experience. 



49 



CHAPTER III. 

ON THE EVIDENCE OF DESIGN, THAT IS AFFORDED BY 
THE EXISTENCE OF DISEASE IN GENERAL. 

One of the strongest arguments adduced by- 
writers upon natural theology, in support of their 
views, consists in the mutual adaptation of one 
part of creation to another, with which it is evi- 
dently associated. Such, for example, is the adap- 
tation of the eye to the physical properties of 
light ; of man's moral constitution to the circum- 
stances in which he is placed ; of the structure of 
the lungs to the qualities of the atmosphere, &c. 
This mutual adaptation is a clear proof that one 
at least of the two associated things, was origi- 
nally constructed with a special reference to the 
other, and that it must have been formed by a 
Being fully acquainted with all the circumstances 
in which it was to be placed, and with all the re- 
quirements it would be called upon to meet. No 
higher proof of wisdom, power, and contrivance, 
can possibly be adduced. 

The argument thus stated is capable of being 

applied, with undiminished force, to the subject 

immediately under consideration. We have, in the 

present condition and character of man, viewed, in 

5 



50 DISEASE, A PROOF 

connexion with his future destiny, an obvious ne- 
cessity for the intervention of some sufficient sti- 
mulus, to direct his thoughts to his best and most 
important interests. This necessity will be more 
fully illustrated as we proceed. We have, on the 
other hand, in the circumstances of the disease an 
arrangement admirably adapted to meet that ne- 
cessity. Who can hesitate to believe that these 
must have been made for each other? Reject 
this idea, and the whole history of disease becomes 
an unaccountable anomaly — a reproach upon the 
moral government of God. Admit it, and all the 
difficulties connected with its occurrence imme- 
diately disappear. The good it produces more 
than counterbalances all the evil it occasions, and 
the object it accomplishes is every way worthy of 
its Author, and of the regard he must be supposed 
to entertain for his dependent creatures. 

That some warning is necessary to remind man 
of his mortal condition, and of the obligation to 
prepare for a future state of existence, is obvious 
from universal observation. How few, as we look 
round upon the world, appear to be in the slightest 
degree impressed with their frail and perishing 
condition. How few appear seriously to think of 
an event that must soon certainly happen, and 
that is fraught with such momentous results to 
their own personal happiness. 

Even of those who do occasionally suffer the 



OF DESIGN. 51 

subject to occupy their attention, how small a 
proportion appear to make the necessary prepara- 
tion for meeting it properly. Were a being of a 
different order in the intelligent creation, to con- 
template the condition and conduct of the human 
race, would he not justly conclude that we were 
labouring under some unaccountable infatuation, 
thus to neglect our highest interests in the unceas- 
ing pursuit of some passing gratification? It is 
impossible to deny that this conduct is really the 
result of an infatuation occasioned by that terrible 
convulsion that unhinged our whole moral being 
at the fall of Adam, dislocated our affections from 
their proper connexion, and deranged the entire 
course of our intellectual operations. But there 
are, besides the natural hostility to the subject of 
religion, that the sacred Scriptures assures us ex- 
ists in every unrenewed mind, two other circum- 
stances which may serve in some measure to ex- 
plain, though they do not justify, this neglect of 
eternal things. These are, the repulsiveness of 
death, as a subject of contemplation, on the one 
hand ; and on the other, the tendency of present 
objects to engross the attention of the moment to 
the complete exclusion of every thing else. As to 
the first of these, many things combine to render 
death, with its associated topics, an unwelcome 
theme. The gloominess of the grave, with its 
dark and dismal silence ; the narrow but inevitable 



52 DISEASE, A PROOF 

tenement that the proudest of the race has to 
occupy; the revolting process of decomposition, 
by which the materials of the body are resolved 
into their original elements ; the intolerable pain 
of parting from the tenderest objects of affection, 
and the most valued possessions and pursuits ; 
the impenetrable mystery that with midnight dark- 
ness shrouds the invisible future; the vague 
conception of the existence of separate spirits with 
their undiscovered relations to each other ; the 
consciousness of guilt that dwells within every 
bosom, until it is taken away in the only mode that 
is revealed for the purpose, and that broods like 
some monster with expanded wings over every 
moment of our waking existence — these and 
similar reflections, rising up on every occasion 
when the subject is brought before us, fill the 
mind with an instinctive dread of its approach, 
and impel us, without waiting to give it time for 
consideration, to banish it as far as possible from 
our thoughts. 

Then, as to the other cause that we have as- 
signed as serving to account in some measure for 
this prevailing neglect of eternal things, we have 
to observe that it appears to be only an abuse of 
a perfectly legitimate principle, wisely implanted 
in our constitution for the best of purposes. The 
principle is this — that whatever subject happens 
to be actually present to the mind, possesses for 



OF DESIGN. 53 

the time an absorbing interest over every thing 
else : in other words, that there is a tendency to 
attend to things in a ratio proportioned, not to 
their importance, but to their nearness. Many 
things may be extremely important in themselves, 
but, owing to particular circumstances, may not 
possess those paramount claims to immediate at- 
tention, that other things of intrinsically minor 
consequence may have. To neglect the latter, 
while attempting to perform the former, would be 
extremely improper. It is evident that to a being 
of limited capacity, and of uncertain life, such as 
man is, present duty, whatever that duty may be, 
is the great object to be attended to: and the 
only question requiring any serious consideration 
is, to determine at each moment of existence what 
that particular duty is that calls for immediate 
attention. The utility of such a principle is ob- 
vious. If man had nothing to guide him in the 
selection of the various duties he undertakes, his 
whole life would be a chaos of confusion. He 
would be in the constant danger of doing every 
thing at the wrong time : attempting at one mo- 
ment something which he may never require, and 
neglecting another he may immediately afterwards 
be in want of. The greatest minds have been 
uniformly distinguished for the two elements con- 
tained in this principle — namely, methodical ar- 
rangement and abstraction of ideas. When they 



54 

take a matter up, they devote to it their undivided 
attention. Whereas, men of considerable ability, 
who have been deficient in these qualities, who 
indulge in a rambling and loose method of study, 
who meditate upon possible contingencies, and 
spend their time in preparing for a remote un- 
certainty, instead of directing all their energies 
to the present emergency, seldom succeed in at- 
taining eminence in any thing. Necessary as this 
principle is for the performance of the ordinary 
affairs of life, it becomes still more so in reference 
to the concerns of the unseen world. But for this, 
it is not unreasonable to suppose, that our thoughts 
would be wholly engrossed with the latter subject, 
to the entire exclusion of every thing connected 
with the present life. We know that this effect 
has been actually produced in many instances. 
The various ascetics who have retired into seclu- 
sion, have done so under this impression: the 
paramount importance of the concerns of the soul, 
weighing down every other consideration in their 
minds, and leading them to spend their time in 
abstract contemplation, to the neglect of the 
active duties of society. It is scarcely necessary 
to remark, that such a course of conduct, how- 
ever well it may work for a limited period, 
is not found, when prolonged for any consider- 
able time, to answer the expectations that had 
been formed of it. In this, as in the opposite 



OF DESIGN. 55 

extreme, there is a fault ; the true interests of 
man requiring a proper balance to be struck 
between the antagonistic principles, so that 
neither the duties of the present hour nor the 
concerns of eternity shall be neglected in the 
adjustment. 

In reference to the nature of those engagements 
that generally absorb the attention, mankind may 
be divided into two principal classes, — the men of 
business and the men of pleasure. The former, 
either from choice or from necessity, select an ac- 
tive and laborious occupation, which taxes their 
energies to the utmost, and involves them in the 
cares and anxieties of the world. The latter are 
usually possessed of independent fortunes, and are 
consequently raised above the necessity of physi- 
cal or mental exertion. They give themselves up 
unreservedly to the gratification of their peculiar 
pleasures or tastes. Different as the life of these 
classes of men naturally is ; different as is the ef- 
fect upon society, the result, as regards themselves 
personally, is pretty much the same. Both are 
drawn into a vortex, which drowns reflection in 
the multitude of present engagements. It is not 
so much that the pressure of business or amuse- 
ment is too great to prevent their actually having 
time to devote to serious subjects, as that they 
have really no taste for their consideration. It 
may fairly enough be questioned, whether any 



56 DISEASE, A PROOF 

man who enjoys personal liberty, no matter what 
his position may be, is so circumstanced that he can- 
not find leisure to prosecute any particular pur- 
suit that really interests him. When this excuse 
is made, as it frequently is, it really means no 
more than this, that the matter is not of such a 
nature as to appear to the individual in question 
"worth the sacrifice of time and convenience that it 
would require. The true way in which the en- 
gagements of business and the fascinations of 
pleasure operate to exclude serious 'thoughts from 
the mind, is by increasing the distaste that exists 
naturally to the subject. Constant occupation of 
the mind in any one way, creates a habit that is 
prejudicial to other pursuits. That very habit 
is productive of a certain amount of pleasure 
in the indulgence, and this is increased the longer 
it is continued. 

Now, if this be really the case — if there be an 
innate indisposition on the part of man to prepare 
for death, and if the ordinary events of life are 
calculated to increase rather than to diminish 
that repugnance, is it not clear that any thing 
which can have the effect of rousing us from our 
lethargy, and of breaking the fatal spell under 
which we are bound, must be highly beneficial, 
even though it be productive of a little temporary 
suffering ? And if disease, with all its drawbacks, 
have an evident tendency to accomplish this ob- 



OF DESIGN. 57 

ject, ought it not to be hailed as an inestimable 
boon to the human race ? 

One of the modes in which it is calculated to 
be of use, is by rendering the tenure of life un- 
certain. Can any thing be better fitted to impress 
the mind with the necessity of timely preparation 
for the approach of death, than the conviction, that 
it is impossible to form any conception before- 
hand of how long we shall live, or how soon the 
fatal period may arrive ? There can be no ques- 
tion that God could, if he had thought fit, have 
provided for the removal of men from the present 
state of existence without the intervention of 
sickness at all. In certain cases, even now, this 
actually takes place, and it only requires the ex- 
tension of the same provision in one or other of 
its phases to accomplish the same result in all 
instances. We find some men killed by fatal acci- 
dents in the enjoyment of perfect health. We 
find others of good constitution living to a green 
old age in the full possession of their faculties, 
till the thread of life is so gently broken, that they 
appear to have never been a day ill. But both 
these forms of death are extremely rare. Death 
by disease is the law of nature. Death, despite 
of disease, is the rare exception. The question 
may be asked, what would be the effect upon 
society were the law altered or reversed? Would 
the change be a beneficial one ? How would it 



58 DISEASE, A PROOF 

answer for men to be left to spin out a longer or 
a shorter period, according to the native vigour 
of their constitutions in the enjoyment of health, 
till the mainspring of activity had lost its power, 
and the curious mechanism within us had become 
worn out by use ? Would it not rather encourage 
that neglect of eternal things, that is now so com- 
mon? Would it not, in a measure, justify a de- 
liberate postponement of the great concern, till 
the lengthening shadows of an autumnal day had 
warned us of the near approach of winter ? and 
even if it should then at length be attended to, is it 
probable that the subject would be more safely 
handled in the dim twilight of declining age, than 
in the broad sunshine of vigorous maturity ? There 
is too much reason to fear that the habit of pro- 
crastination, which is at present so much to be 
deplored, would then be greatly increased. The 
certainty of the continuance of health, and of the 
slow approach of death, would operate to lull our 
fears to sleep, and when once this effect had been 
produced, it would be extremely difficult to waken 
them again in sufficient time to make the neces- 
sary preparation. 

Nor would the occasional occurrence of violent 
death from accidental causes, tend, in any 
material degree, to disturb that result. We know 
that, at present, the extreme rarity of such events 
operates effectually to prevent their exercising 



OF DESIGN. 59 

much influence on the mind; and even were their 
number to be considerably increased, they would 
still be destitute of many circumstances that attend 
an attack of sickness, and that are peculiarly 
fitted to make an impression upon the spectators. 
Were men to be generally removed from the world 
in this way, by a sudden stroke, in the midst of 
youth, and health, and activity, without a warning, 
and without a moment of preparation, it is to be 
feared that the consequences would be most de- 
plorable. Every man's mind would be occupied 
by an ill-defined and indescribable dread of im- 
pending danger — his aptitude for business would 
be destroyed — the zest of pleasure would be 
quenched ; but the subdued and salutary tone of 
mind that is induced by the prolonged and pre- 
paratory process of the ordinary attacks of illness 
would be altogether wanting. 

How different from this is sickness ! How 
admirably is it fitted for the particular purposes 
it is intended to effect ! Though it does occasion- 
ally accomplish the work of destruction in a 
moment, as in apoplexy, and some forms of 
hemorrhage ; yet, how rare is the occurrence ! 
Usually it heralds its approach by some note of 
warning, and the citadel is seldom taken until the 
close of a more or less protracted siege ; so that the 
inhabitants can enjoy the full confidence of se- 
curity until the enemy has formed his lines of 



60 

investment. And yet, while it thus effectually 
guards against the formation of a settled gloom 
on the mind, which would necessarily follow were 
it to be continually oppressed with a sense of im- 
pending insecurity, it answers the other equally 
necessary purpose of preventing the growth of 
indifference, that would be produced by the 
universal enjoyment of protracted old age. It 
waits not till the leaves that have played in the 
summer breeze have turned yellow to shake them 
to the ground. It spares no age, nor sex, nor 
condition. All are equally exposed to its devas- 
tating influence — all are equally obnoxious to its 
remorseless stroke. It is this that makes every 
funeral that passes along the streets a solemn 
warning to the spectators. They may know 
nothing of the name, or age, or history of him 
who is thus carried in solemn silence to his final 
resting-place. They may, perhaps, care to know 
nothing of these things, as they hurry past to 
their business or their pleasure. Yet it speakes in 
impressive tones notwithstanding. They cannot 
look upon the dark emblems of the mournful 
procession without being sensibly reminded of the 
uncertainty of life, and without the question 
being involuntarily suggested to their minds, who 
knows how soon I may be carried in a similar 
manner to the house appointed for all living? 
Were death an event limited to the old and grey- 



OF DESIGN. 61 

headed, all this salutary impression would be done 
away. The young and thoughtless might then 
look on in unconcern, secure in the consciousness 
of having a long life to spend, before the dread 
disturber of their enjoyment would approach. 
Nor is it merely by rendering the duration of life 
uncertain that disease operates thus beneficially 
in awakening attention to eternal things. No ; 
it tends at the same time, in a remarkable manner, 
to deepen the solemnity of the event, and to touch 
the feelings of the survivors. An unexpected 
casualty may terrify by its appalling suddenness ; 
it may create a blank in the social circle ; it may 
distress the immediate relatives by taking away 
their principal support ; yet it must always want 
much of that impressiveness which it is so desirable 
to secure by the very rapidity of the stroke. 
Disease, on the contrary, as we have said, seldom 
accomplishes its task without some interval of 
warning. Can. any thing be conceived better 
adapted to make a serious impression upon the 
spectators than this very circumstance ? When 
death enters a family, it is no longer an abstract 
speculation, seen at a distance, and little regarded. 
It comes home with a force to every member of 
the household, which it is impossible to exaggerate. 
How much is there in the suffering of the patient 
to remind an intelligent spectator of the frailty of 
his own nature. How much in the expressions and 
6 



62 DISEASE, A PROOF 

temper of the sick man to awaken serious self- 
examination. And then the length of time that 
he lies upon the dying couch, though it may 
familiarize in some measure the mind with the 
solemn scene, is certainly calculated to prevent 
its being easily forgotten. Still further, look at 
the impression that is made upon society at large. 
Not only the immediate connexions of the indivi- 
dual are made to feel that death has been among 
them, but even casual strangers have the same 
truth forced upon their attention, though not to 
the same degree. Every death that takes place 
in the active period of life creates a blank in the 
circle of society of greater or less extent, in pro- 
portion to the position the individual occupied. 
Just as the gigantic elm, when prostrated by the 
winter hurricane, has the earth widely torn up by 
its roots ; so society is convulsed by the removal 
of every man of position and of active usefulness. 
How many chains are broken by the dropping of 
a single link ! How may plans are disarranged ! 
How many helpless dependents are thrown upon 
the world. New occupants, it is true, fill the 
vacant places ; but the change is generally striking 
and permanent. Every one feels that the ruthless 
hand of the grim tyrant has been at work. Even 
in this aspect the force of the impression derives 
much of its strength from the age at which men 
generally die. Were it to occur in advanced life 



OF DESIGN. 63 

only, how little would the event effect the sur- 
vivors. Very old men usually retire from the 
active duties of life long before this event reaches 
them. They are buried in the bosom of their 
families, and excite no interest among the public. 
They are forgotten and unheeded. Even to their 
immediate relatives their removal is rather a 
release than a calamity. Pressed down by the 
weight of years, they are a burden to themselves 
and to every one around them. Like a shock of 
corn fully ripe, whose attachments have been all 
dried up and withered, they fall gently to the 
ground, and leave no scar behind. Death by 
disease evidently makes a greater impression upon 
society than death by old age ; and in so far as it 
does, it answers a useful purpose. 

But there is still another purpose, of a some- 
what different character, which disease serves to 
accomplish, and that deserves to be noticed — 
that is, its affording a fitting field for the exercise 
of the charities of our nature. The tender graces 
that have survived the fall of man, and that still 
shed a lustre upon his character in its present 
degraded condition, require to be called into 
activity, before their force and beauty can be dis- 
covered. The glory of God requires them to be 
displayed, in order that He may receive the praise 
that His handiwork is so justly entitled to. The 
interest of man himself equally requires them to 



64 

be brought out into active exercise, in order that 
they may be strengthened and increased. Like 
the muscles of the body, they must be used if they 
are to retain their vigour and to grow. It is in 
subservience to this object that the web of society 
has been so closely knit together by the cords of 
sympathy and self-interest, and that so many 
circumstances occur to call for mutual co-operation. 
At no period of our existence are we rendered 
completely independent of our fellow-men. From 
the cradle to the grave we are continually re- 
ceiving in one shape or another, some material 
assistance from those around us, without which it 
would be impossible for us to exist; the design 
of which is evidently to promote harmony and 
good feeling between the various members of the 
race, by the necessary interchange, from time to 
time, of the little acts of kindness that these 
necessities call forth. But at no period is 
this more apparent than when we are stretched 
upon a bed of sickness. In the intense severity 
of pain ; in the feverish excitement of the nervous 
system ; in the protracted loss of sleep, there is 
every thing calculated to call forth the tender 
attentions of a susceptible heart. And it is seldom, 
indeed, that such a call is not responded to. The 
most desolate, the most abandoned of the human 
family generally find in those trying seasons some 
generous spirit to speak a word of kindness, and 



OF DESIGN. 65 

to minister to their wants. All their former errors 
are overlooked in the overwhelming conviction of 
their present necessities. But when sickness 
appears in circumstances favourable to the full 
development of the finer feelings of our nature, 
how beautifully are they exhibited. The skill of 
the physician; the sympathy of friends; the 
anxiety of the immediate relatives ; the tenderness 
of the mother ; the devotedness of the wife, are 
all exerted to the utmost. No means are then left 
untried to ease the aching head, to quiet the 
apprehensions of an agitated mind, or to subdue 
the agony of bodily suffering. With what self- 
denying devotion, at such times, will a faithful 
friend watch at the bedside for nights together, to 
discover the least change in the symptoms of the 
disorder, and to minister to the slightest of the 
patient's necessities. With what exquisite gentle- 
ness is the least alteration in the sick man's position 
effected. With what eager anxiety is a discovered 
want supplied, or a suspected wish anticipated. 
How often does the period of sickness prove to be 
an occasion for making a man acquainted with a 
number of real friends, who take an interest in 
his welfare, but who were previously strangers to 
him. What delicate little attentions are then 
paid even by casual acquaintances, which would 
be carefully avoided at another time, lest they 
should be considered intrusive. 
6* 



06 DISEASE, A PROOF OF DESIGN. 

Is it not well that there should sometimes be 
an opportunity afforded for such a gratifying dis- 
play as this ? Can any thing be conceived more 
calculated to promote the best understanding, and 
the kindest feelings between man and man, than 
the interchange of these acts of attention ? Can 
any thing be more really beneficial to the person 
who is engaged in performing them than the very 
exercise in question ? 

We have yet some other advantages to notice, 
as resulting from the existence of disease; but 
we may be permitted to ask, before proceeding, 
do we not see sufficient, in what has been already 
advanced, to justify us in drawing the conclusion, 
that there are wise and useful ends answered by 
this instrumentality, which, so far as it is possible 
for us to determine, could not be accomplished by 
any other arrangement ? 



67 



CHAPTER IV. 

ON THE VARIETIES OF DISEASE AS IMPLYING DESIGN. 

We have hitherto confined our attention to the 
mere fact, that such a thing as disease exists in 
nature, without considering whether it is uniformly 
the same destructive process in all cases, or whe- 
ther it assumes, as we know it does, different 
forms in different cases. If there has been any 
force in the argument, as already presented to the 
reader, it becomes still more conclusive, when the 
latter circumstance is taken into account. So far 
as the mere object of rendering the duration of life 
uncertain is concerned, it is obvious that it might 
have been as effectually secured by a single ma- 
lady attacking different individuals as by a mul- 
titude. For the age at which men would die in 
that case, would be just as various as at present. 
There would be no more reason for any man cal- 
culating on his living to a fixed age then, than 
there is, under existing circumstances, of his calcu- 
lating on his living to a century. For example — 
let us suppose that men, instead of dying of a 
multitude of different complaints, as we know 
happens at present, were to die of one disease 
only, and that one consumption, what would be 



68 ON THE VARIETIES 

the result? Would it necessarily occasion them 
to die at one fixed and unvarying age ? Not at 
all, there would still be a very great diversity in the 
periods of life, at which different individuals would 
die. We have selected this complaint, because it, 
more than any other, is supposed to be invested 
with the property of proving fatal at a particular 
epoch. That epoch, within certain limits, is pretty 
accurately observed. But though these limits are 
sufficiently extensive, we by no means find the 
ravages of the disease strictly confined to them. 
Multitudes of cases occur both before and after 
them. Nor is this difficult to be accounted for. 
The development of the complaint in the first in- 
stance, as well as the rapidity of its progress, are 
both regulated by two independent elements, 
which to a certain extent influence each other. 
These are the constitutional predisposition, and 
the exciting cause. When these act in conjunc- 
tion, and when they are highly developed, the 
result is proportionally accelerated. When, on the 
contrary, they are but slightly developed, or, as it 
were, act in opposition, the fatal issue is retarded. 
The consequence is, that both the commencement 
of the disorder in any instance, and the interval 
required for it to arrive at maturity, are extremely 
uncertain. 

These two circumstances, the epoch of the 
commencement of the disorder, and the rate of its 



OF DISEASE. 69 

progress, necessarily exercise an important influ- 
ence on the period of its final termination, and 
therefore render the age of its victims essentially 
uncertain. Now, if this be so in reference to a 
disease, whose constitutional origin is so obvious, 
how much more forcible is the argument when 
applied to the attacks of fever, severe inflamma- 
tions, and other maladies, whose development is to 
be traced to the operation of external influences 
alone, inasmuch as these latter depend upon cir- 
cumstances which may act at any period of life, 
and which it is impossible to foresee or avoid. 

But though the effect, taking it for granted 
that the design of the existence of fatal disease 
is, in part at least, to render the duration of life 
uncertain, would be equally secured by a single 
malady as by a multitude, the impression of that 
uncertainty is infinitely greater in the latter case 
than in the former. Not only the number of dis- 
eases, but the variety in their symptoms, duration, 
and progress, has a tendency to augment this effect. 
Who can tell what form the grim invader may 
assume when the assault is made upon himself — 
whether he shall come with the slow but unerring 
step of cancer or marasmus, or whether he shall 
surprise the citadel of life by cholera, apoplexy, 
or aneurism? Even when a well-marked predis- 
position to some hereditary complaint gives a sort 
of assurance, that a man's removal from the world 



70 ON THE VARIETIES 

shall be accomplished in a particular way, how 
often is the calculation cheated of its fulfilment 
by the unexpected advent of some new and fatal 
seizure of a different kind. If a single disease 
were employed by the supreme Disposer of events 
for this purpose, the human mind would soon be- 
come familiarized with its various phases, and in 
that familiarity much of the impressiveness of the 
present lesson would necessarily be lost. 

But here it may be said, as an objection to this 
view, that if the purpose for which the Divine 
Being has made life uncertain be, to induce us to 
make a suitable preparation for the approach of 
death, so that our eternal destiny in a future 
state may be a happy one, this object would be 
more effectually accomplished by the appointment 
of a single malady, instead of a variety, provided 
it were a lingering one, such as consumption. 
Such an arrangement, it may be thought, would 
give every man a timely warning of the approach 
of death, and a sufficient interval to make the ne- 
cessary preparation to meet it properly. Whereas, 
at present, owing to the rapidity of some maladies, 
and the attending circumstances of others, no man 
can be sure of enjoying these advantages. In some 
cases reason loses its dominion from the very 
moment of seizure, and the opportunity of prepa- 
ration never returns. In others, though the in- 
tellect remains clear enough for the purpose, the 



OF DISEASE. 71 

interval is too short, or the pressure of other mat- 
ters too great, to allow of this subject being pro- 
perly attended to. In others, again, the confu- 
sion incident to the crisis, the absorbing endeavour 
to allay the patient's suffering, and the delusive 
hope of recovery, occupy the time fully till the 
opportunity is irretrievably lost. And in other 
cases still, though the danger is imminent, the in- 
dividual himself is not aware of his situation ; and 
his friends, in their anxiety for his welfare, peremp- 
torily forbid the slightest allusion to the subject, 
lest the announcement should be productive of 
injury, and the feeble hope of amendment should 
be utterly extinguished. All this, it is imagined, 
might be avoided by the substitution of a different 
system. But even though it should be conceded 
that a death-bed repentance would more frequently 
follow such an alteration in the arrangement of 
disease, it by no means proves that the Infinite 
Disposer of all things has either erred or been 
deceived in making the appointment in question. 
His design evidently was, not so much to bring 
men to a death-bed repentance, as to impress 
them with a sense of the danger of postponing 
their eternal interests to the uncertain issue of a 
dying hour : that so they might be constrained to 
lay these things seriously to heart in the full 
vigour of their health and strength. Viewed in this 
light, there can be no question, that the existing 



72 ON THE VARIETIES 

arrangement is infinitely better adapted to fulfil 
its purpose, than the one under consideration. 
Even as it is, multitudes we know are found mad 
enough to act upon the chance, that they shall yet 
have time enough allowed them, before the fatal 
issue shall occur, to answer all the purposes that 
are required ; and under this impression they give 
themselves up unreservedly to the gratification of 
the passing moment. How would the number of 
such persons be increased ; how would their con- 
fidence be augmented, if they were to be assured 
by an established law of nature, that their removal 
from the present scene of existence would be a 
tedious process, accompanied by unerring symp- 
toms of its approach, and affording them, in the 
unclouded possession of their faculties, a full 
opportunity of at last learning to be wise ere it 
should be too late. 

But it may be questioned with great reason, 
whether the proposed arrangement would really 
accomplish the object that is here taken for 
granted : whether, in fact, a death-bed repentance 
would even, under these favourable circumstances, 
be more common than it now is. Before, how- 
ever, proceeding to consider this point, it may be 
well to notice a preliminary objection to the sup- 
posed arrangement, and that is, that such a course 
of proceeding — an unvarying disease, acting uni- 
formly in all cases — would be altogether at vari- 



OF DISEASE. 73 

ance with the rest of the divine works. In no 
part of God's creation are we able to detect a 
dull uniformity. All nature teems with an end- 
less profusion of diversities. The birds of the air, 
the cattle of the field, the fishes of the sea, the 
very plants of the earth, all exhibit, in matchless 
beauty and in inconceivable number, this remark- 
able feature. Nor is it confined merely to the 
distinction that prevails among the separate species 
of each kind of animated nature, and which may 
be supposed to have their origin in the constitu- 
tion and wants of those species. It is carried to 
an infinitely greater depth, and it displays itself 
in circumstances where no consideration of the 
kind can be supposed to exist. Individuals of the 
same species, whose uses and nature are the same, 
are yet strikingly unlike. Surprising as it is to 
think, that in the countless millions of the human 
race no two individuals are exactly alike, yet it 
is infinitely more surprising to know, that no two 
leaves in the forest are accurately similar; for 
while the former require, in the purposes of God, 
to be distinguished from each other, with a view 
to their identification in a state of retribution, no 
such reason can be adduced to account for the 
latter. 

This law of dissimilarity, if we may so speak, 
seems to have been formed, in addition, perhaps, 
to other reasons, for the purpose of impressing 
7 



74 ON THE VARIETIES 

us with a sense of the infinite vastness of that 
omnipotent intelligence, that can thus strikingly 
diversify the works of His hand, while He im- 
presses them at the same time with the unmis- 
takable evidences of His wisdom, and goodness, 
and care. And why should this variety exist every- 
where but in disease? If it were absent there, 
would not this very absence lead us to infer that 
it could not be really the work of God, since it 
would be so clearly deficient in one of the plainest 
attributes of all His works ? 

This very variety then serves an important 
purpose in the chain of reasoning, that traces up 
the existence of sickness to the hand of Him who 
made the earth and the heavens. 

But there is a special reason for this variety, 
derived from the consideration that man is an ac- 
countable being, and as such subject to the direct 
moral government of God. It is needless to 
remark, that all God's creatures, so long as they 
exist, must be under His control and government. 
But the laws which regulate their movements 
differ remarkably, according to the nature they pos- 
sess. For example — matter, from its unconscious 
and passive character, is possessed of no power to 
modify or control the external impressions to which 
it may happen to be exposed. The properties of 
mutual attraction and repulsion, in proportion to 
its mass, produce uniform and unvarying effects, 



OF DISEASE. 75 

because there is no inherent power of resistance 
in the dead elements of which it is composed. 
When we ascend in the scale of creation to living 
organized beings, whether vegetable or animal, 
we discover a real inherent principle of resistance 
to the external circumstances in which they may 
happen to be placed. It is not perhaps absolutely 
perfect, but it is at all times apparent ; and the 
higher we proceed the greater does it become. 
In the inferior animals, for example, the control 
under which they are placed, partakes more or 
less of the character of physical necessity. In 
them the governing principle that regulates their 
voluntary actions, is instinct — a faculty that acts 
with a rapidity, an accuracy, and a propriety that 
far exceeds the slower processes of intellect. And 
while this faculty, in one sense, may be considered 
as regulated by the volition of the animal, inas- 
much as it always corresponds with its agreeable 
emotions ; in another it is not so, being controlled 
entirely by the external circumstances in which 
the animal, for the time, may happen to be placed. 
The design of the creation of the inferior animals, 
we have reason to think, was not so much to 
answer an end connected with themselves, as to 
fulfil a subordinate purpose connected with the 
human race. They are not accountable agents, 
and hence it is not necessary that each individual 
among them shall be treated in a manner calcu- 



76 ON THE VARIETIES 

lated to make his actions peculiarly distinct. They 
are grouped into masses, rather than isolated as 
individuals. Except so far as domestication by 
man is concerned, the members of every species 
have been placed, since their original creation, in 
the same general circumstances. At birth, and 
throughout life, each individual has the same ad- 
vantages and the same disadvantages as the rest 
of the species. The later members are not more 
knowing, more comfortable, or more civilized than 
the earlier. 

But when we come to man how different is his 
position. What diversities prevail throughout the 
race, not only in different ages of the world, but 
in the same age and in the same country. How 
different the rank, comfort, education, and ad- 
vantages of one man from those of another. No 
two individuals appear to be placed in precisely 
similar circumstances. Every thing connected 
with his being proclaims that he is a creature of 
a distinct order from the inferior animals, and 
formed for a different purpose. It is his consti- 
tution as an intelligent creature, and his responsi- 
bility as a moral agent, that cause all the difference ; 
and the great truth which it is intended to force 
upon his attention is, the individuality of his 
character and conduct. He is not to be led 
blindly by a few general principles, in the same 
manner that instinct produces its effects, without 



OF DISEASE. 77 

his knowing why, and without his taking time to 
inquire. He is to reason upon all he does, and 
to be satisfied of the propriety of any course, 
before he hurries into it. Neither is he to be a 
servile imitator of others, who may appear to be 
placed in a position similar to his own. The 
possession of reason enables him to form an 
opinion upon every question that comes before 
him; and the whole circumstances of his con- 
dition emphatically declare that the entire re- 
sponsibility of his conduct rests upon himself 
alone. Now, if this be true, is it not apparent 
that any thing which would have a tendency to 
weaken this conviction — that any thing which 
w^ould lead men to suppose that they were 
governed by general principles solely, and would 
be subject to a common and not a personal re- 
sponsibility, w r ould certainly prove injurious to 
their real interests, inasmuch as it would lead to 
a less careful examination of their individual 
actions, and a less anxious consideration of the 
consequences resulting from them. 

Such an effect, to a certain extent at least, 
would be produced by the appointment of one 
unvarying mode of death, acting uniformly in all 
cases, inasmuch as it would destroy the analogy 
of nature, and disturb the harmony that exists in 
the arrangements of life. 

But to resume. A little consideration will lead 

7* 



78 ON THE VARIETIES 

us to conclude that the substitution of a linn-ering 
disease for the present uncertain system, would 
not be calculated to effect the end intended. So 
long as health continued, men would evidently be 
less concerned about a future state than they are 
at present; calculating, and with reason, upon 
receiving warning in sufficient time to enable 
them to make the requisite preparation. Its 
only effect would evidently be, to lead them to 
postpone the duty till the necessity for its per- 
formance should arise. Now let us suppose any 
individual actually attacked with the premonitory 
symptoms of the fatal disorder — which we shall 
imagine to be consumption — would he be imme- 
diately ready to enter upon that duty which he 
has so long and so frequently postponed ? Would 
not the very idea that the disease would be pro- 
tracted, exercise a soporific influence upon the 
mind, and lead him to procrastinate still further 
till the symptoms should become more marked, 
and the danger more urgent? And when once 
this fatal habit has been formed, would it not 
acquire strength with each additional indulgence, 
till at last the opportunity, so long and so 
graciously vouchsafed, should be hopelessly lost ? 
Besides, it must not be forgotten that in con- 
sumption, and indeed in other lingering complaints 
also, there are two circumstances which materially 
interfere with the patient being convinced of his 



or DISEASE. 79 

condition, and so being prepared to derive that 
warning from the invasion of the malady that the 
hypothesis supposes. These are first, the long 
period during which, in many cases, the disease 
remains latent, by which it is to be understood, its 
existing without the obvious signs of its develop- 
ment ;* and, secondly, the long period during which 
the hope of recovery continues to prevail. This, 
notwithstanding the assurances of the attending 
physicians, and the manifest marks of an incurable 
malady, will often delude the victim till the last 
moment of existence ; so that he is frequently 
persuaded in his own mind, immediately before 
the fatal event, that he is about to get speedily 
and permanently well. 

But it must not be forgotten that disease is not 
sent into the world for the sole purpose of re- 
minding us of our approaching death, and warning 
us to prepare for it. Were it so, disease would 
be uniformly fatal. They would not exhibit those 

* This point is particularly deserving of attention. Owing 
to the latency of the disorder, a man is often far gone in con- 
sumption before he is either himself personally aware of the 
fact, or his most intimate friends have suspected it, so gentle, 
in many cases, is the approach of the fatal event. Louis, 
one of the highest authorities on the subject, states, that fully 
a fifteenth of all cases are latent during some part of their 
progress, often extending from six months to two years. — 
[Sydenham Edition, p. 432.) In such cases the warning, if 
previously relied on, would be fearfully indistinct. 



80 ON THE VARIETIES 

differences in severity that we find extending, from 
the most trifling indisposition, to the most alarming 
illness. A death-bed repentance, and a satisfactory 
settlement of accounts, before the final audit, is 
what every man wishes for, whatever his conduct 
during life happens to be ; and if he could be sure 
of these, little else would trouble him. But this 
is not the design which God has formed for man ; 
neither is it consistent with his real happiness. 
What God intends, and what man really requires, 
is that his whole life should be under the influence 
of religion ; in other words, that he should enjoy 
habitually communion of soul with God, and be 
possessed of peace in that communion. In this 
point of view the slighter forms of illness are 
calculated to prove peculiarly useful. They bring 
home to every man's door the consciousness of 
his own mortality. They change a mere im- 
pression, floating in the mind, but little thought 
of, into a stern reality, actually felt and ex- 
perienced. Like the expostulations of the 
prophet, they apply their warning directly to 
the offender, and say, "Thou art the man/' In 
many respects the slighter attacks are more 
useful, in awakening serious attention, than those 
which are fatal. In the latter, even when the 
intellect remains clear, and the patient has time 
to reflect, the conviction of impending death so 
overwhelms the mind and fills it with terror, that 



OF DISEASE. 81 

it is unfitted for seeking reconciliation with God. 
In the former this apprehension is absent, and the 
mind is, consequently, calmer in its operations. 
In fatal attacks the patient has often no interval 
free from pain. In mild ones, the period of con- 
valescence is eminently calculated to allow of quiet 
and profitable reflection. 

For these reasons, then, it is wisely arranged 
that there should be not only fatal diseases to 
remove man from his present sphere of ex- 
istence, when he has spent, like an hireling, his 
day, but mild ones also; and we shall find, 
as we proceed, that one of the most remarkable 
features connected with the eourse of disease is, 
the number and variety of provisions they pre- 
sent, to ward off danger, and to convert mala- 
dies, that would otherwise be incurable, into 
curable ones. 

But, independently of the advantages already 
hinted at, as presented by the slighter forms of 
illness over the more serious, is it not obvious 
that the recovery of the patient enables him to 
exhibit, in his subsequent conduct, the happy 
results of the affliction he has gone through. 
Society is but little the better for any alteration 
in a man's views that takes place upon his dying 
bed. But when he is permitted to rise up from 
his illness a new character and a better man, how 
great is the advantage. His whole conduct is 



82 ON THE VARIETIES 

changed. His example, his influence, his admo- 
nitions are all productive of good to the circle in 
which he moves. 

There are three obvious ways in which every 
attack of illness is calculated to produce a bene- 
ficial impression upon the mind. First, in sus- 
pending the ordinary engagements of life. How 
many are so absorbed in business or pleasure that, 
were it not for the interruptions thus occasioned, 
their minds would never be taken off their farms, 
their merchandise, or their usual pursuits. Yet, 
when sickness comes, necessity lays its iron hand 
upon the struggling victim, and obliges him to 
desist ; the mind becomes no longer capable of 
thought; the intellect is clouded, and the feeble 
frame, helpless and incapable of exertion, is 
chained to its chamber and its couch. Even when 
he awakes from the unconsciousness of stupor, 
or the ravings of delirium, how long is it before 
the exhausted mind can apply itself to its wonted 
occupations. All this is evidently designed in 
mercy to the patient. The second way in which 
illness proves useful is, in lowering the tone of the 
spirit. In the heyday of health how prone is 
man to feel confident in his own resources, and 
independent of the Great Being from whom he 
derives his existence. He is ready to say, with 
the Egyptian king, "Who is the Lord, that 
I should obey his 70100?'' But the case is 



OF DISEASE. 83 

altered when the exuberance of health has depart- 
ed. Not only does the strong man become weak, 
but the valiant man becomes timid; a sense of 
sinking occupies the soul, and there are misgivings 
within. This arises from the connexion subsisting 
between the physical organization of the body and 
the intellectual principle. The third way is, in 
affording an interval for quiet reflection between 
the period of attack and the resumption of employ- 
ment. In all these respects it has a vast supe- 
riority over other forms of affliction, which are 
sometimes used in the economy of grace for the 
accomplishment of the same object; and it exhibits 
a peculiar suitableness for producing all those 
effects that a careful examination of man, and his 
condition, shows us to be necessary for his present 
happiness and his future welfare. 



84 ON THE PAIN 

CHAPTER V. 

ON THE PAIN OE DISEASE, AS EVIDENCING DESIGN. 

There is no symptom more generally present in 
disease, or more striking in its character, than 
the pain that accompanies it. It is this which 
renders the visitation so trying to the generality 
of patients, many of whom, especially in the higher 
ranks of society, would endure, without complain- 
ing, all its other inconveniences, were it not for 
the personal suffering it occasions. And it is this, 
more than any thing else, which has given rise to 
the idea, that illness is to be regarded as a judicial 
visitation, and as an expression of the divine dis- 
pleasure against the person afflicted. This idea 
rests upon the supposed connexion between 
punishment and suffering, as cause and effect ; 
but, however constantly associated these two 
ideas may be in the mind, there is no necessary 
connexion between them in reality. We often 
meet with what is intended as a punishment, 
where there is really no suffering, and vice versa; 
as for instance, in human tribunals, where, owing 
to the limited and imperfect power of the judge, 
it becomes impossible to render the decision of 
the court sufficiently effective on the one hand; 



OF DISEASE. 85 

and on the other, where an innocent person falls 
unjustly under suspicion, and suffers imprison- 
ment previous to trial. 

It will scarcely be denied that nothing ought 
properly to be considered as a punishment, which 
is not intended to be such. This is obviously the 
case in the proceedings of human tribunals ; and 
it is equally true in reference to the divine govern- 
ment. But in investigating the subject in the 
latter point of view, the difficulty consists in dis- 
covering what is really the intention of the Great 
Moral Governor in any appointment of His pro- 
vidence. Many persons are in the habit of speaking 
very loosely upon matters of this kind. They 
discover, in the conduct of an individual, or of a 
community, a certain thing, which is admittedly 
improper ; and they discover subsequently, in the 
experience of that individual or community, some 
calamity; and they forthwith infer, on the post 
hoc propter hoc principle, that the calamity is 
designed • as a punishment for the misconduct. 
But this appears to be altogether an unwarrant- 
able course of proceeding. Even when we are 
able to trace an obvious and close connexion 
between the supposed cause and effect, we are to 
determine the divine purpose in the appointment, 
by a careful examination of the whole aspect and 
circumstances of the events, rather than by the 
single element of suffering. 
8 



86 ON THE PAIN 

Take the case of a father who squanders his 
property in idleness and vice. His family are 
plunged, in consequence, in all the horrors of 
want and wretchedness. The opinion commonly 
entertained of such a case is, that the children 
are punished for the improvidence of the parent. 
But this is evidently an erroneous idea. They are 
the innocent victims of another's guilt ; and, as 
such, though involved in the consequences of his 
misconduct, are not amenable to punishment. 
The father, it is true, is punished in the loss of 
comforts, to which he was previously accustomed ; 
in the contempt of the world ; in the neglect of 
his former associates; and, above ail, in the 
consciousness of having been the means of ruining 
his family. But, so far as the children are con- 
cerned, the whole train of events may prove a 
blessing instead of a calamity ; it may place them 
beyond the reach of temptations they would have 
been unable to withstand ; and it may lead them 
into positions of greater activity, usefulness, and 
comfort, than they would otherwise have occupied. 

The mere circumstance, then, of any person in 
the present life being exposed to suffering, is no 
proof that he is obnoxious to punishment, or that 
he is peculiarly subject to the divine displeasure. 
On the contrary, it may be laid down as an 
indisputable position, that, wherever we can 
discover, in any arrangement of the kind, plain 



OF DISEASE. 87 

and obvious proofs of a wise and salutary purpose, 
to be accomplished by the appointment, we are 
justified in considering it as an evidence of the 
tender care exercised over His creatures by the 
Great Disposer of all things. 

This is emphatically the case with the pain of 
sickness. Though always irksome to those who 
are the subjects of the attack, and often almost 
intolerable, it requires but a little attention to 
discover that it is fraught with the most beneficent 
advantages to the human race, and that it exhibits 
at once the wisdom and the goodness of Him from 
whose appointment it proceeds. 

I shall first speak of the useful ends that pain, 
considered generally, accomplishes in disease, 
without referring to its intensity or peculiar 
character; and I shall, subsequently, direct at- 
tention to the more striking modifications that it 
exhibits in different cases, with a view to show 
that the very variations of the symptom only tend 
to confirm, in a stronger manner, the soundness of 
the conclusion we have arrived at. 

The first, and most obvious purpose that it is 
intended to serve is, to give us timely warning of 
whatever deviations from a state of health happen 
to take place in any part of our bodies. Were it 
not for this, many diseases would occur without 
the patient being cognizant of their having 
happened. With the exception of the class of 



88 ON THE TAIN 

dislocations, the mechanical inconvenience of 
which gives timely notice of their occurrence, we 
should be ignorant of almost all the other acci- 
dents or diseases we are subject to, only for the 
pain that attends them. Bones are often broken 
without the person's knowledge, so much so, that 
the surgeon who detects the nature of the acci- 
dent finds it difficult, from the little suffering it 
induces, to persuade the patient to believe that 
he has met with so severe an injury. Again, 
persons in fever are occasionally found pursuing 
their ordinary avocations, and even walking con- 
siderable distances, after they have been attacked, 
to their own manifest injury, simply because the 
absence of pain has destroyed all consciousness, 
on their part, of their being unwell. Connected 
with this use of pain, and arising immediately 
from it, is the service that it renders to the 
individual, in prompting him to take effective 
measures for the recovery of his health so soon as 
he has been warned of the actual invasion of 
illness. The means which nature has provided 
for the restoration of the body to its original 
healthy condition may be divided into two classes. 
One, independent of human agency, consists 
in the secret arrangement of certain salutary 
processes, which act by themselves, without the 
volition or consciousness of the individual. The 
other depends upon the exercise of his own 



OF DISEASE. 89 

faculties, which direct him to adopt the requisite 
measures for his benefit that reason and experi- 
ence prove to be best adapted for the purpose. 
The first of these classes require no warning 
sentinel to stimulate them to vigilance. At the 
moment their services are needed they are found 
busy at their posts. But the second is essentially 
dependent upon the friendly notice that the pain 
we have been considering usually gives of the 
approach of disease. 

When a man fractures one of his ribs, the in- 
jury considered by itself, is not of much conse- 
quence. The chest can still be expanded and 
contracted sufficiently for the purposes of respi- 
ration, by means of the other bones of the thorax 
which retain their integrity. But though of trifling 
importance abstractedly, it may lead to secondary 
results of the very highest moment. The ends of 
the broken bone striking against the delicate 
membrane that lines the chest, may give rise to 
inflammatory action of such intensity, as to en- 
danger life, or it may produce effusion of fluid, 
and thus permanently embarrass the breathing of 
the patient. The pain, however, which such a 
state of things invariably induces, calls attention 
at once to the danger, and leads to the adoption 
of appropriate treatment for its removal. 

In the treatment of fractures, as indeed in all 
other processes of reparation in the animal frame, 
8* 



90 ON THE PAIN 

the vital forces of the part are the great agents 
in bringing about the union of the bones. All that 
the surgeon can do is, to place the parts in the 
most favourable position for the purpose, and to 
assist nature, as far as may be necessary, by ap- 
propriate constitutional management. It follows 
from this, that when the parts have been properly 
adjusted, and the bandages applied, it is to be 
regarded as a settled principle in surgery, not to 
interfere with them unnecessarily afterwards. In- 
deed, if it were possible to maintain them accu- 
rately in the same position in which they were 
first skillfully placed, it would be every thing that 
could be desired. But unfortunately this is not 
the case. Several circumstances concur to dis- 
turb the result, such as the utter impossibility of 
a patient maintaining, all through the tedious pro- 
cess, the same unvarying posture day and night ; 
the impossibility of controlling altogether the 
muscular action of the limb ; and the impossibility 
of counteracting entirely the force of gravity, 
which acts silently but constantly upon the sepa- 
rated fragments; — these, however carefully the 
surgeon may endeavour to prevent their produc- 
ing their natural effects, will still in time, more 
or less, alter the position of the parts, so that if 
care were not taken to prevent such an occurrence, 
it w r ould be found at the completion of the pro- 
cess that the union had taken place in an un- 



OF DISEASE. 91 

natural manner ; the limb being more or less 
shortened, and the bone twisted on itself to the 
manifest inconvenience and annoyance of the 
patient. Here, then, the sensations of the patient 
furnish useful information for the management of 
his case. So long as the parts retain their proper 
relative position, so long he feels the limb com- 
fortable and free from uneasiness : but as soon as 
they depart from that position, pain is produced. 
It is thus seen that a most valuable help is afforded 
in this way to the determination of the important 
question, whether the bandages should be opened 
at any moment, or whether they should be left 
undisturbed, so as not unduly to interfere with 
the process of union on the one hand, and not to 
suffer it to proceed in an improper manner on the 
other. The development of pain infallibly gives 
notice, that all is not going on as it ought to do, 
and puts both the patient and the surgeon on their 
guard, while its absence, on the contrary, is a tole- 
rably sure evidence that matters are proceeding 
favourably to their determination. 

Another purpose which is served by pain is, 
that it materially assists the physician in determin- 
ing the seat and nature of many of the internal 
ailments which the body is liable to, but which, 
from their position, present considerable obscurity 
at first. This is the case with inflammation of 
the liver, lungs, stomach, brain, &c, the treat- 



92 ON THE PAIN 

ment of which, though possessing certain points 
in common, differs in each case according to the 
difference of their structure and function. To 
enable the practitioner to decide the proper course 
to be pursued, he must be able to determine 
beforehand what is the particular affection he is 
called upon to manage. Yet this is often a matter 
of some difficulty. The constitutional symptoms 
in all are so very much alike, that no material 
assistance can be derived from that source ; and 
although there are other symptoms of a pe- 
culiar character depending upon the form, posi- 
tion,* and office of the different organs, which, 
when discovered, leave no doubt upon the mind 
as to the nature of the affection, yet they are 
generally too obscure in their earlier stages, and too 
slowly developed, to answer the purpose of giving 
an exact and timely intimation for the purposes 
of diagnosis. But the pain of the attack comes 
in opportunely to assist in solving the difficulty : 
it appears at the onset, just at the very moment 
when its indications are of most importance, and 
it points out, generally with great accuracy, the 
part of the body principally engaged, and which, 
but for the hint thus given, might very possibly 
have been overlooked. 

In proof of this statement we have only to 
look to those diseases which are scientifically 
denominated "latent." Absence of the usual 



OF DISEASE. 03 

characteristic symptoms is the prominent feature 
of the class : hence the name. Thus a person may- 
be labouring under inflammation of the lungs, and 
yet have no cough, no difficulty of breathing, no 
expectoration, nor even any obvious degree of 
fever. Such cases are not uncommon. So trifling 
may be the patient's indisposition, that he may 
not be aware of his real state, and may scarcely 
be inclined to credit it when first informed of the 
fact. The same thing may happen in inflamma- 
tion of the pleura — the membrane that covers the 
spongy texture of the lungs. We may have an 
amount of fluid in the chest sufficient to produce 
enlargement of the side, and to displace the heart 
and other viscera, without the ordinary symptoms 
that such an affection is calculated to produce. 
Now, what is it causes the latency of these and 
similar affections? What is it stamps upon them 
that obscurity beneath which they form and ad- 
vance, till mechanical alterations are produced 
that force themselves upon our notice, and pro- 
claim in unmistakable language the mischief that 
has occurred? Doubtless, it is the absence of 
pain, or its scarcely perceptible amount. Had it 
been more acute in the onset, it would have at- 
tracted the attention of the patient himself, and 
have imperatively called for that relief which 
would have prevented the ailment proceeding to 
such a height. 



94 ON THE PAIN 

Another useful purpose that the existence of 
pain secures in the animal economy, is the im- 
position of a restraint upon the use of diseased 
parts, without which it is impossible for recovery 
to take place. It has been already stated that 
nature herself is the great agent in the work of 
cure. For the accomplishment of her task it is 
absolutely essential that her operations should not 
be interfered with, but that they should be allowed 
to proceed uninterruptedly in their proper course. 
Hence, perfect quietude is a necessary condition 
of their successful termination. If a man sprain 
his leg, and the parts become inflamed, he must 
cease to walk on it before he can get well. If the 
eye become attacked by ophthalmia, he must wear 
a shade, and give up the use of reading before he 
can reasonably hope for relief. All this is proved 
by every-day experience ; but men are naturally 
so impatient of all restraint upon their personal 
liberty, and the calls of pleasure or of business 
are generally so urgent, that it is often a matter 
of much difficulty to induce them to submit to the 
confinement that is necessary for the recovery 
of their health. Were it not for the pain that 
attends the use of diseased organs, many persons 
would not be induced by any considerations to 
submit even to the most trifling privation, but 
would pursue their ordinary avocations utterly 
regardless of the consequences. But the actual 



OF DISEASE. 95 

suffering that each indulgence in this pernicious 
course is sure to entail, as well as the relief that 
is produced by the opposite line of conduct, gene- 
rally succeed in constraining most men to act in a 
way consistent with their real interests. It is 
owing to the little pain that attends the slighter 
forms of indisposition that many of them run a pro- 
tracted course, until they become difficult of cure, or 
lay the foundation of permanently impaired health. 

We have still another instance, in the process 
of parturition, of the beneficial effects that pain 
is capable of producing, though the process 
itself does not properly belong to the cate- 
gory of disease. This is exemplified in its pro- 
perty of restraining for a time actions, that, if 
permitted to take place, would be attended with 
injurious results. Every one knows the severity 
of that trial which a woman has to endure when 
she is about to become a mother ; insomuch, that 
the expression has passed into a proverb, to denote 
agony of peculiar intensity. It may reasonably 
be inferred, that if there be any truth in the views 
put forward in this essay, there ought to be dis- 
coverable in this process some peculiar advantages 
resulting from the arrangement, where the suf- 
fering is s© great; that this is really the case, 
has been clearly established by the most scientific 
observations. 

The process itself requires a certain interval 



96 ON THE PAIN 

of time, for the purpose of having those changes 
effected in the maternal organs that are neces- 
sary for the safety of both mother and child. 
Any thing that would tend to hurry forward 
the process before these changes have been 
effected, is found to be in the highest degree 
injurious. In the production of the changes 
themselves two mechanical forces of different 
kinds are employed — one the voluntary efforts 
of the mother, acting through the medium of 
muscles, which are subject to her will; the other 
a set of involuntary structures which act of them- 
selves, and which she has no power to control. 
In the earlier stages it is the latter set of forces 
that are employed, and until they have accom- 
plished their work the former can only embarrass 
the proceeding. But the natural impatience of 
the mother, ignorant as she is of the importance 
of remaining quiet at this time, can scarcely be 
restrained till the proper period has arrived at 
which her efforts can be put forth with advantage. 
She is thus prompted by the feelings of the 
moment, to make exertions which are not only 
useless but injurious. The pain, however, that 
nature has planted as a sentinel on this trying 
occasion effectually restrains such premature at- 
tempts, till the period has arrived at which they 
may be safely permitted, and just as that period 
approaches the character of the sensation alters, 



OF DISEASE. 97 

and the intensity of the suffering diminishes, so 
that the mother is enabled to put forth the full 
power of expulsion at the very moment when it is 
most needed. It is foreign to the purpose of the 
present essay to enter into the controversy that has 
been raised between the advocates and opponents 
of anoesthetic agents, relative to the question, 
whether it is justifiable or not, on religious grounds, 
to resort to such expedients in ordinary cases, 
because, whichever view be adopted, the utility 
of the pain must be admitted. In the one case, 
where nature is left to herself, the pain acts as a 
safeguard, by delaying for a time the contractions 
of the voluntary muscles; in the other, where an 
artificial expedient is resorted to, the pain is su- 
perseded, but the state of insensibility that is 
induced answers the same purpose, by allowing, 
as the advocates of chloroform maintain, the invo- 
luntary contractions, which are not under the con- 
trol of the individual, to proceed undisturbed. 

Who can reflect upon those various uses of pain, 
without being struck with the goodness that 
prompted the Divine Being to attach such a pro- 
vision to our constitution ; and with the wisdom 
that presided over the contrivance? Who can 
enough admire the simplicity of the means on the 
one hand, or its sufficiency on the other ? Let us 
suppose for a moment, that this mode of indica- 
ting the existence of disease were done away — 
9 



98 ON THE PAIN 

that the beneficent Author of nature were to 
reject a condition so distressing to his creatures, 
what substitute can we imagine Him to supply 
in its place, that would at all answer the purpose ? 
It is quite clear, that if it is to be a symptom that 
will give notice of morbid action of any kind taking 
place in any part of the frame, it must be a modi- 
fication of the patient's natural sensibility: nothing 
else would awaken his attention to the fact of such 
a change having occurred ; and if the sensibility 
be modified, how else can it be modified except 
in the way of pain ? No sensation that is merely 
indifferent would accomplish the object, much less 
would one that was agreeable. Either of these 
might call attention to the fact, that a change had 
taken place in the vital action of some of the 
organs, but they would not alarm him by the idea 
of danger ; they would not excite him to take im- 
mediate steps for the correction of the evil ; they 
would not impose upon him the restraints neces- 
sary for his perfect recovery. Pain, on the con- 
trary, is a symptom universally understood; its 
voice is immediately heard; its mandates are not 
lightly to be disregarded. So far as we can see, no 
other provision could be devised that would effec- 
tually accomplish the same objects, while free from 
the suffering that the present one is attended with. 
Besides the foregoing, which may be called the 
physical uses of pain, because they have especial 



OF DISEASE. 99 

reference to the preservation of the physical 
structure, there are others, no less interesting and 
important, which have reference to man as a moral 
agent, and which may be denominated its moral 
uses. The first of these I shall notice is, its forc- 
ing upon the mind a conviction of the frailty of 
our nature, and awakening it to serious reflection. 
It is not saying too much to assert, that were all 
kind of suffering removed from disease — were it 
possible for a man to be seriously ill, and yet 
enjoy all his accustomed pleasures, it would be 
impossible for him, constituted as he is, to derive 
any lasting benefit from the visitation. As it is, 
we know that multitudes are attacked with illness 
who never derive any real advantage from it, but 
this is in some measure caused by the pains that 
misguided friends take at such times to conceal 
the patient's real danger, and to occupy their 
thoughts with other matter. But there would be 
no necessity for such well intentioned, but most 
mistaken kindness on the part of relatives, were 
there no suffering connected with sickness. A man 
could then inspect his ledger, prosecute his 
studies, transact his business, with as much facili- 
ty almost as he could in health, and in the oc- 
cupation of the moment forget his danger and his 
duty. But happily for mankind this is not usually 
the case. The suffering of a sick bed effectually 
banishes all such employment, and unless the 
conscience be thoroughly killed, the mind, how- 



100 ON THE PAIN 

ever reluctantly, is compelled to have the alarming 
conviction of its mortality and responsibility forced 
upon its attention. 

But a second moral use of pain consists in its 
lowering the tone of the spirit, and so preparing 
it for a more suitable consideration of these 
important topics, than it would be likely to give to 
them in health. Under ordinary circumstances 
the mind is puffed up with pride, and with a feel- 
ing of its own independence. The mysterious 
connexion subsisting between the physical organi- 
zation of our bodies and the intellectual prin- 
ciple within us, favours this spirit ; and we reject 
with haughty disdain, when in the vigour of health 
and youth, the solemn considerations of our weak- 
ness and dependence. But let the scene be 
changed. Let a few short hours of sickness pass 
over us ; let the weakness of an emaciated frame, 
of protracted sleeplessness, of intense agony, be 
felt, how soon is the lofty spirit humbled; how 
soon the proud boaster silenced. When the visi- 
tation of sickness is sanctified, much of the benefit, 
under the influence of Divine grace, is to be traced 
to its effects in thus altering the temper and the 
sentiments of the party. 

But one of the most beautiful effects of pain 
remains to be mentioned. We have already in a 
manner alluded to it when speaking of the 
uses of disease in general ; but it is the pain 
of disease that is chiefly instrumental in bring- 



OF DISEASE. 101 

ing it about. The idea referred to is its ten- 
dency to develope kind feelings between man and 
man; to excite a friendly sympathy on the part 
of others towards the person immediately afflicted. 
No sooner is an individual attacked with illness, 
than a corresponding degree of interest is excited 
on his behalf. Expressions of solicitude for his 
welfare are put forward, oifers of assistance are 
made, old friendships are revived, new ones are 
developed: all this, it is to be remembered, is 
essentially connected with the suffering of sick- 
ness. Were it not for this, there would be no 
occasion for this sympathy, and there would be no 
manifestation of it. Every man would be left to 
battle with the attacks of illness as he could, and 
no friendly voice would be raised to cheer him in 
his hours of solitary gloom ; no tender hand put 
forth in offices of kindness ; no midnight watcher 
volunteer to nursetend his bedside. In contem- 
plating the uses of pain, that a gracious God has 
thus attached to our constitution as a necessary part 
of our existence, is there any one that calls for 
louder admiration than this, which unites the whole 
family of Adam into one universal brotherhood; 
which gives exercise to the noblest charities of our 
nature, aud which is the means of securing to us, 
at the very moment when we most see their value, 
the tenderest assistance of the best and kindest of 
our race. 

9* 



102 THE MODIFICATIONS 



CHAPTER VI. 



It is scarcely necessary to remark, as the cir- 
cumstance must be familiar to every one, that the 
pain of disease does not preserve in all cases the 
same uniform character and intensity ; on the con- 
trary, it preserves the greatest possible variety in 
these respects, even under circumstances which 
at first sight would lead us to expect a tolerably 
exact resemblance. It becomes therefore a ques- 
tion for consideration, how far these differences, 
when closely examined, serve to confirm the position 
already laid down as to its general utility. 

These differences depend partly upon the na- 
ture of the structure attacked, partly upon the 
character of the morbid action present at the time, 
and partly upon certain peculiarities connected 
with the constitution of the individual: and the 
more closely they are examined, the more clearly 
will it appear that they do not occur at random, 
but are the result of a wise arrangement in every 
instance, and that the very things that at first 
sight appear to form exceptions to the rule, only 
tend, on further inquiry, to add force to the argu- 
ment and to confirm its accuracy. 



OF PAIN. 103 

I shall commence the observations I intend to 
bring forward on this subject, by analyzing a few 
of the more striking varieties of pain that we meet 
with, selecting the examples from familiar instan- 
ces, and then proceed to consider the objections to 
the theory that are likely to be raised. 

And first, as to the severity of the pain. This, 
as every one knows, varies from the most trifling 
alteration in the patient's sensations, scarcely de- 
serving the name, to the most acute agony that 
the human frame is capable of enduring. Now, 
it may be stated as a general rule in the history 
of disease, that the severity in most cases bears 
a direct ratio to the danger of the affection. 
When an organ, essential to life, is attacked, or 
when the inflammatory action rises high, the 
whole constitution sympathizes with the mischief, 
and the pain becomes proportionally great. But 
when, on the other hand, a part of less importance 
happens to be engaged, or the inflammation as- 
sumes a lower type, there is not the same neces- 
sity for immediate alarm, and the pain is of a less 
marked character. 

In illustration of this I may take the case of 
the serous membranes — a set of textures which 
perform a most important part in the animal 
economy. They are attached to all the joints, and 
line the great cavities of the chest, cranium, and 
abdomen. The purpose they subserve is, to faci- 



104 THE MODIFICATIONS 

litate the movement of one part upon another by 
destroying friction. For this end they are admi- 
rably adapted, being smooth upon their free 
surface, and being perpetually moistened by 
a vapoury dew. When in health they are 
totally destitute of sensation ; and the wisdom 
of their being so is conspicuous in the fact, that 
w r ere they sensitive, every movement of our bodies 
would be productive of inconvenience, if not of 
pain. But whenever they become diseased, their 
sensibility is exalted to the highest possible degree. 
One of the largest and most important of these is 
called the peritonoeum : it covers the intestines. 
While it admits of the freest movements taking 
place in the long folds of the alimentary canal, it 
effectually ties them down in their proper posi- 
tions, and prevents their becoming entangled with 
each other. And although a perpetual change of 
position is taking place between the several parts, 
the individual, so long as the membrane retains its 
healthy condition, is unconscious of the movement, 
or even of its existence. Let it become inflamed, 
however, and the whole state of things becomes 
painfully altered. The patient can no longer 
turn himself in bed, nor stand upright ; he cannot 
breathe with ease, nor bear the slightest touch 
upon the abdomen. He lies immoveable on his 
back, his knees drawn up, and his body bent for- 
ward, to relax as much as possible the muscular 



OF PAIN. 105 

tension ; while such is the tenderness of the in- 
flamed surface, that even the weight of an ordinary 
blanket thrown over the bed, becomes an intole- 
rable burden, from the trifling pressure it occa- 
sions. All this amount of suffering bears an 
evident proportion to the necessity of the occasion, 
warning the patient of his danger, and stimulating 
him to adopt the speediest and most energetic 
measures for his recovery; because there is an 
obvious necessity for the preservation of this 
membrane in its integrity for the future purposes 
of digestion ; and still more, because the form of 
inflammatory action, to which it gives rise, is one 
of the most rapid and most fatal to which the 
human frame is liable. 

Let us take another instance from the case of 
inflammation of the heart, or pericarditis, as it 
is technically called. I need not say that such an 
affection as this is fraught with the highest danger. 
The necessity that exists for this organ main- 
taining uninterruptedly its office, as the great 
moving power of the circulation — the force-pump 
of the blood, as it may be considered — and the 
facility with which its delicate mechanism may 
be permanently injured, concur to render it a 
matter of the greatest moment, that the earliest 
possible intimation should be given of its being 
attacked by disease. This is provided for suffi- 
ciently by there being added to the pain, that is 



106 THE MODIFICATION 

common to the ordinary attacks of inflammation, 
a peculiar and indescribable kind of distress — 
an internal and unaccountable feeling of alarm 
and anxiety. Patients thus affected, do not in 
general reveal their suffering by clamorous out- 
cries and violent gesticulations, Such efforts 
would only increase the evil by hurrying the cir- 
culation. Their manner, on the contrary, is calm, 
their tone subdued, but their anguish is depicted 
in legible characters on the countenance ; so much 
so, that an experienced physician will sometimes, 
from this peculiar expression, be enabled to guess 
with tolerable accuracy the nature of the com- 
plaint. Is there not wisdom then displayed in the 
intensity of that pain, that points in such a manner 
to the dangerous condition of so Tr ital an organ ? 

We have another instance of violent pain in the 
case of mortification, the earlier stages of which 
are attended with extreme suffering. It is seldom 
that ordinary inflammation exhibits any tendency 
to assume this destructive character. It is, hence, 
attended with pain of a comparatively mild kind. 
But whenever, from the severity of the injury, 
or some peculiar condition of the constitution, 
such an untoward result is about taking place, we 
have a corresponding increase in the violence of 
the patient's sufferings. And will it be asserted 
by any one worthy of the least attention, that the 
circumstances do not justify the change ? Will it 



OF PAIN. 107 

not, on the contrary, be regarded that nature, by 
this symptom acting the part of a faithful sentinel, 
is ever ready to give notice of the approach of 
danger ; but, true to her trust, instinctively sounds 
the loudest alarm when she sees the danger to be 
greatest ? 

Let us now turn to examples of an opposite 
kind, to cases where the pain is trifling, and we 
shall see that in them the danger, if it exists at all, 
is considerably less in amount or urgency. Take, 
for instance, the form of inflammation that prevails 
in persons of a scrofulous constitution. This is 
proverbial for the small amount of inconvenience it 
occasions to the patient. He suffers, frequently, 
no pain ; he is able to pursue his ordinary avoca- 
tions, and his usual enjoyments are not interfered 
with. The parts this kind of inflammation attacks 
are principally the lymphatic glands of the neck, 
armpits, &c, organs which play a very subordinate 
part in the economy of life. The character of the 
morbid action itself is remarkably chronic; it 
undergoes its changes slowly ; often remains sta- 
tionary for years, and seldom tends to generate 
the ordinary products of inflammatory action. In 
all this there is no apparent necessity for sounding 
an alarm in the patient's ear, by attaching to the 
ailment pain of an acute kind. The life of the 
individual is not at stake ; all the animal functions 
are performed with tolerable exactness, and the 



108 THE MODIFICATIONS 

only unpleasantness the patient often is exposed 
to, besides the mechanical inconvenience of the 
bulk of the tumor, is the mental sense of deformity 
to his personal appearance. 

A second class of diseases, attended with very 
little suffering, are those latent affections to which 
allusion was made in the last chapter. These, as 
I have already stated, are often of the greatest 
importance, threatening the life of the individual, 
if not immediately, yet at no distant period. It 
will naturally be thought, that if pain is necessary 
to give warning of danger, its services are certainly 
requisite here. And so undoubtedly it is, but not 
altogether to the extent that may be supposed. 
There are peculiarities connected with the history 
of latent diseases that render the absence of this 
symptom, or its less pronounced severity, of less 
importance to them than it would otherwise be. 
Like the scrofulous affections just mentioned, they 
appear to originate in an unusual condition of the 
constitution; but they differ from them in the 
nature of the morbid action, as well as in the seat 
which it occupies. On the other hand, they differ 
from the ordinary attacks of common inflammation 
in the slower rate of their progress, and in the 
absence of constitutional sympathy. The morbid 
action present in both is the same; the tissues 
engaged the same; the tendency the same; the 
danger to life the same. But the low form that 



OF PAIN. 109 

the inflammation assumes causes it to proceed 
with less rapidity in its course, and accounts, 
in a great measure, for the obscurity of the 
symptoms; changes that are gradually brought 
about being productive of little inconvenience, 
because the system is enabled to accommodate 
itself to the altered circumstances in which it is 
placed. This slowness, then, though it does not 
diminish the ultimate danger, allows of sufficient 
time for treatment to be adopted before permanent 
disorganization has taken place, and supersedes, 
in some measure, the necessity for a louder warn- 
ing at the commencement. 

Another class of affections characterized by the 
little amount of suffering that attends them, con- 
sists of the various forms of insanity. This, though 
a disease of the highest importance to the well- 
being of the individual, and though its effects are 
most deplorable upon the understanding, is not, 
in general, attended by much personal suffering, 
either of mind or body. On the contrary, the 
large majority of the inmates of a lunatic asylum 
are not only as happy in themselves as those who 
enjoy the perfect use of their understanding, but 
usually a great deal more so. The propriety of 
this is obvious. The complaint in question does 
not, by itself, materially tend to destroy life, or to 
shorten the natural limit of its duration. It ex- 
hausts itself principally upon the powers of the 
10 



110 THE MODIFICATIONS 

mind, rendering the patient incapable of discharg- 
ing the relative duties of society. The very 
element of such a condition may be said to consist 
in an unconsciousness of his own state. To what 
purpose then, it may be asked, should there be 
added to it a symptom whose office, in the very 
-nature of things, is to give notice, not to the 
friends and neighbors of the individual attacked, 
but to himself? The addition of local pain to the 
loss of reason would obviously answer no useful 
purpose. It would not make the patient one 
whit more conscious of his state than he is without 
it, or lead him more readily to resort to the neces- 
sary treatment for his recovery ; and, as far as his 
friends are concerned, how could they be apprised 
of the existence of such a symptom, except from 
his own statements, and if they were, what 
assistance would it afford them in estimating his 
mental condition, beyond what they already pos- 
sess in his conversation and conduct. 

If the views advocated in this paper be correct, 
it is scarcely necessary to remark, that the great 
use for which pain is appointed in disease is, to 
direct attention to the malady with a view to its 
proper treatment, and hence, that its presence is 
most important at the commencement of the 
attack. When once this object has been attained; 
when the patient has been sufficiently apprised of 
his condition, there is the less necessity for its 



OF PAIN. Ill 

continuance afterwards. This accounts satisfac- 
torily for a feature in the intensity of the 
symptom, that must be universally known; that 
is, that it is most severe at first, and becomes 
gradually milder. This fact may be accounted 
for in various ways; but the object intended to 
be gained by its occurrence is evident enough. It 
is no part of the divine purpose to subject His 
creatures to unnecessary suffering. Benevolence 
forbids that it should be protracted one moment 
longer, or carried one particle farther, than w r as 
absolutely requisite for the accomplishment of 
His wise intentions. Hence we find various pro- 
visions instituted to mitigate the violence of pain 
in the progress of disease. One of these consists 
in the production of certain changes in the struc- 
tures — the consequence of inflammatory action — 
that interfere with the sensibility of the part. 
For example, when the serous membranes are 
attacked, a copious amount of fluid is poured into 
their cavities, which separates their free surfaces 
from each other, and thus prevents their highly 
sensitive portions from irritating one another by 
mutual friction. Some of the most striking 
instances of this merciful provision we find to be 
connected with the approach of death ; a remark- 
able remission in the symptoms usually occurring 
some hours before the close of life. Thus, in the 
case of gangrene, to which allusion has already 



112 THE MODIFICATIONS 

been made, there is commonly a complete cessa- 
tion of pain in the part, and the patient expresses 
himself as greatly relieved and perfectly comfort- 
able, so much so, that the sanguine relatives 
anticipate, from this circumstance, a speedy 
restoration to health. But the experienced 
physician regards the change as an evidence of 
an opposite result having taken place. The 
textures having become dead, having lost all 
power of sensation, are incapable any longer of 
transmitting to the sensorium those impressions 
upon which the previous agony of the patient 
depended. In severe fevers, as well as in other 
mortal maladies, the same thing constantly occurs. 
Changes are produced in the brain which cause, 
more or less complete insensibility to surrounding 
impressions, which, though distressing to the im- 
mediate relatives to witness, is full of mercy to 
the patients themselves. Can any arrangement 
be imagined more full of tenderness than this? 
What useful purpose would it serve for the dying 
man to be racked with pain at the moment of 
dissolution ? to feel . the loosening of the silver 
cord, and the breaking of the golden bowl, when 
the rushing tide that filled it has at length ceased 
to flow ? Whatever services pain could previously 
have rendered, it is no longer capable of being 
of any use. 

Another modification of pain that deserves con- 



OF PAIN. 113 

sideration is, the intermitting character it oc- 
casionally presents. Instead of being permanent 
during the entire period of the malady, it subsides 
for a time, to recur again with the same violence 
as before, though the conditions upon which it 
appears to depend continue all through. The 
most remarkable examples of this occur in cases 
of tic-douloureux, and other neuralgic affections. 
Some of these are caused by the pressure of a 
tumor on the filaments of a nerve ; and, as the 
cause is permanent, it would naturally be expected 
that whatever pain it might occasion would be 
permanent also. But this is not the case. With 
a view to mitigate such sufferings, which are often 
of agonizing intensity, nature has provided that 
there should be intervals of rest, during which the 
afflicted patient might have ease. Were it not 
for this, life itself would be insupportable. The 
nature of the nervous fluid serves, in some 
measure, to explain the phenomena, consisting, 
as it appears to do, of a series of interrupted 
impulses, and not of a continuous stream, and 
requiring certain intervals of repose to prevent its 
energy being exhausted, and to enable it to fulfil 
its function. 

But whether this explanation be correct or not 

is a matter of little consequence; what we are 

mainly concerned with is the fact itself, of which 

there can be no question, and in which there is 

10* 



114 THE MODIFICATIONS 

conspicuous the same tender regard for the 
children of affliction that we have been able to 
trace in other departments of nature. 

In some spasmodic diseases, epilepsy for example, 
though the contortions are frightful to look at, we 
are probably not warranted in concluding that 
the patient suffers much, or, indeed, any pain, at 
least at the time ; because his sensibility is des- 
troyed by the circumstances of the fit. But this 
is not the case in others. In Asiatic cholera 
consciousness is preserved in all its integrity, and 
the patient suffers frightfully from the cramps ; 
but here we have developed those occasional inter- 
missions of which we have been speaking, and 
which minister a certain amount of ease to the 
patient, though it must be confessed it is neither 
very great nor very permanent. 

The last modification I shall allude to is the 
circumstance of the pain occasionally undergoing 
a change in its character, according to the stage of 
the complaint. In other words, we have a double 
pain in certain affections, one kind corresponding 
to the earlier stage, and another to the later ; so 
that we are able, by questioning the patient upon 
this point, to ascertain, with tolerable exactness, 
how far the morbid process has advanced. For 
example, when an abscess is forming in any part 
of the body, the pain is at first of an acute 
throbbing kind, which changes to a dull aching 



OF TAIN. 115 

sensation at a later period, when the contents of 
the abscess are becoming purulent. Now, although 
this circumstance, by itself, would not warrant a 
surgeon in concluding that it is time to make an 
incision into the part; yet it is obvious that a 
knowledge of the peculiarity must afford him 
material help, in conjunction with other symptoms, 
in arriving at a satisfactory solution of this im- 
portant practical question. Similarly, we find 
the pain of parturition to possess a twofold 
character, corresponding to the stages of that 
process ; so that it is perfectly possible, from this 
circumstance alone, (and what is still more re- 
markable, from the change in the character of the 
woman's cries, as expressive of the character of 
the pain,) to determine the progress that a case of 
labour has made to its ultimate completion. In 
this instance again there is plainly perceptible a 
useful purpose to be served by the modification of 
the symptom. 

I come now to consider the objections that may 
be urged against the views here advocated, and 
in doing so, I shall take notice of all that occur 
to me, as at all likely to be started, and state 
them as fully and as fairly as I can. The first then 
is this : that we frequently find the amount . of 
pain, differing widely where the disease is the 
same, and when it is impossible, consistently with 
the opinion here advocated, to account for the 



116 THE MODIFICATIONS 

difference. Thus, one patient labouring under 
consumption will suffer very little, while another 
will suffer a great deal, though the circumstances 
of each may appear as nearly as possible similar. 
If the pain depended upon the nature of the mor- 
bid action, or were in any measure intended to 
act as a salutary guard upon the danger of the 
patient, it ought to be the same in both cases. In 
reply to this, I think it may be very fairly ques- 
tioned, whether the assumption is really borne 
out by facts: whether two cases, really similar 
in their pathological conditions, are ever attended 
with different degrees of pain. But even if this 
were to be admitted, it does not follow that there 
is the least force in the objection. It is not said 
that the sole object for which pain exists is, to 
give warning of the danger : there are other pur- 
poses it is intended to serve, as has already been 
shown, and the necessity for these being accom- 
plished, may exist in one case and not in another. 
Thus, there may be occasion for the development 
of the moral ends of pain, in cases where there is 
not the same necessity for the development of the 
physical. Still further, if there be any truth in 
the observations made in a former chapter, rela- 
tive to the variety in the Divine dealings, towards 
his intelligent creatures, and in the purpose for 
which that variety is intended — namely, to indi- 
vidualize them as much as possible, and to impress 



OF TAIN. 117 

them with the idea of a special Providence pre- 
siding over and directing every thing that hap- 
pens to them, it must be obvious, that such 
diversity, if it exists, is but a part of a great 
plan, intended for the wisest and the best of pur- 
poses. The objection, if it do not rest on a base- 
less conjecture, is capable of being perfectly 
reconciled with the idea of intelligent contrivance. 
A second objection may be stated thus: — Many 
severe and even fatal diseases are unattended 
by that amount of pain, that is commensurate 
with their danger. Some of these cases have 
been already considered when speaking on the 
subject of latent diseases, and reasons were ad- 
duced to account for the absence of the symptom. 
In other cases where there is great and urgent 
danger, it will, I believe, be generally found that 
there are other indications of the illness, sufficiently 
distinct to enable the parties to form an opinion 
upon the subject, and to direct the treatment. 
Take the instance of apoplexy. A man, appa- 
rently in perfect health, suddenly falls down in a 
fit, bereft of sense and motion, from which it is 
impossible to rouse him. Here, though the life 
of the patient is threatened, and that in the most 
sudden and alarming manner, yet he does not 
generally suffer any considerable amount of pain. 
Yet, what is the loss in consequence ? Is it neces- 
sary to point out to the bystanders the grave 



118 THE MODIFICATIONS 

nature of the attack? Would a consciousness of 
pain on the part of the patient, who lies sprawl- 
ing helplessly on the ground, give a greater 
clearness to the warning, than is conveyed by the 
circumstance and suddenness of the seizure? 
Is it not a more merciful provision to draw 
the curtain of insensibility over a condition, 
which, were the patient at all conscious of its 
nature, would be most distressing to his feelings. 
The absence of pain is accounted for by the 
absence of consciousness, but the place of the 
former is in these instances sufficiently supplied 
by other symptoms that answer the same end. 

The last objection I shall notice is one per- 
plexing enough to answer satisfactorily. It is 
this: the existence of severe and long-continued 
pain, where no vital organ is concerned, where 
the life is not placed in immediate danger, and 
where the malady is incurable. Such, for ex- 
ample, are those cases of neuralgia, to which 
allusion has already been made; and such also 
are the various forms of cancer. It is not easy to 
see what useful purpose — at least of a physical 
kind — such intense suffering can answer. But are 
we warranted from this circumstance in conclu- 
ding that it really does not answer any. Even 
if it were impossible to discover any satisfactory 
reason for this appointment, analogy would lead 
us to conclude, from what we are able to see of 



OF PAIN. 119 

the Divine works in other parts of this arrange- 
ment, that there are wise and sufficient reasons 
for its occurrence, although we are not able as 
yet to discover them. It is fairly to be expected, 
that in investigating the works of the Infinite Crea- 
tor, we shall find many things beyond the reach 
of our comprehension. But are we on that ac- 
count justified in questioning their correctness. 
Let us argue from what is known to what is un- 
known, and let us infer from the clear and pal- 
pable proofs of wisdom, benevolence, and skill 
that surround our path, that if we were put in 
full possession of all the facts of the case, we would 
clearly discover that the present phenomenon 
forms no exception to the universal character of 
His administration. 

But this answer, though it may silence the ob- 
jector, is not likely to satisfy him. Happily for us, 
we are not left to such dark conjectures. In the 
moral uses of the appointment we have abundant 
purposes to be answered in every way worthy of 
the great Governor of the universe. Intimately 
acquainted, as He is, with the peculiar constitu- 
tion of every individual mind, He sees in those 
cases where He is pleased to send the affliction, 
some great and imperative necessity for a process, 
that appears to our limited comprehension so 
painful and so mysterious. Just as in reducing 
ores, taken from the earth: the miner finds it 



120 THE MODIFICATIONS OF PAIN. 

necessary to resort to different processes to se- 
parate the metals from the cruder particles with 
which they are associated in nature, and to aug- 
ment the temperature of the furnace in certain 
cases that are peculiarly refractory; so w^ may 
be sure that He who sits as a refiner and purifier 
of silver, uses the crucible of trial with equal dis- 
crimination, and adapts the character of the afflic- 
tion, and the intensity of the ordeal, and the 
period of its duration, with unerring skill, to the 
special circumstances of each individual case. 



121 



CHAPTER VII. 

OF SOME OTHER SYMPTOMS OF DISEASE AS EXHIBITING 
DESIGN. 

We proceed to direct attention in the present 
chapter to some other prominent symptoms of 
disease that, like golden threads shining through 
a cloth of dark texture, enable us to discover the 
pattern worked upon the surface. 

In doing this we shall confine ourselves to a 
few examples out of many, and shall select those 
only which are familiar to most ordinary readers, 
and which are so obvious in their character as 
not to be open to any reasonable objection. 

The first we shall allude to is the occurrence of 
nausea at the commencement of ordinary fever. 
This symptom is invariably present, if not at the 
very beginning of the disorder, at least at an 
early period after its development. It consists, 
not simply in a mere loss of appetite, but in a 
positive distaste to all kinds of food, so much so, 
that the very sight of any solid aliment, is sufficient 
to create disgust in the mind of the patient. It 
is a remarkable circumstance that this change in 
the ordinary sensations of the individual occurs at 
a time when the appetite for drinks is not only 
11 



122 VARIOUS SYMPTOMS 

continued, but actually increased. It may at first 
sight be thought a matter of surprise that these 
two sensations, so closely connected, and so nearly 
akin in their essential office, should be so differ- 
ently affected by the same morbid action. Yet 
there are wise and salutary reasons for the dif- 
ference. For while the copious use of diluting 
drinks is unattended with inconvenience, and is 
even productive of advantage, the ingestion of 
solid food, on the contrary, would be most perni- 
cious, disturbing the comfort of the patient, and 
prolonging the duration of the attack. To under- 
stand this clearly it is necessary to call attention 
to the difference that exists in the mode by which 
the liquid and solid elements of nutrition are 
taken up into the system. The former, from the 
simplicity of their constitution, require to undergo 
no preparatory process before they are absorbed 
into the vessels provided for their reception : 
almost immediately after being swallowed they 
are found circulating in the general mass of the 
blood. But the latter, on the contrary, owing to 
the complexity of their composition, and their 
insoluble form, require to undergo changes in 
their structure before they are capable of being 
taken up into the economy. Hence they require 
for this purpose, not only a certain interval of 
time, but a certain expenditure of vital force. 
These changes, which constitute the principal 



OF DISEASE. 123 

part of what is commonly called digestion, are not 
a mere solution of the solid portions of the food 
in the fluids of the system, but a peculiar modi- 
fication of the nature of the substance brought 
about by the action of the gastric juice, aided by 
the energetic contraction of the coats of the sto- 
mach. Now, when the patient is oppressed by an 
attack of fever, this process is entirely suspended, 
both because the secretion of the gastric juice, like 
all the other secretions of the body at such a time, 
is arrested, and still more, because the muscular 
fibres of the stomach partake of the debility 
which is apparent everywhere else, so that they 
are incapable of performing their proper duty. 
It is manifest that when matters are in this state, 
the use of food would be attended with decided 
disadvantage; as it could undergo none of the 
changes necessary to assimilation, it would neces- 
sarily lie as a heavy mass within the stomach, 
inconvenient from its weight and bulk, and still 
more so from the fermentation that its peculiar 
position would be sure in a short time to induce. 

But to understand fully the value of this pro- 
vision, it is necessary to extend our consideration 
a little further. In the brute creation the quan- 
tity of nutriment taken at a time by any animal 
is regulated altogether by the appetite of the 
moment. Instinct, guided by the senses, is the 
sole and sufficient guide to direct him when to 



124 VARIOUS SYMPTOMS 

eat and when to desist. He knows nothing of 
future wants, and he can form no conjecture as to 
the circumstances in which he may possibly be 
placed, so as to make provisions for contingencies 
that may subsequently arise. If he can gratify 
the cravings of his present sensations he is fully 
satisfied, and makes no attempt to guard against 
a future necessity. But the case is different with 
man. His intelligence raises him above the 
narrow limits of the present hour, and imposes 
on him the necessity of making suitable provision 
for the approaching future. This feeling operates 
in respect to the taking of food as well as to every 
thing else. Hence the promptings of sense are 
always to a certain degree subordinated to the 
higher dictates of reason. This subjection of the 
animal appetite to the views of an enlightened 
expediency evidently has its advantages, and if it 
could be exercised on all occasions with due dis- 
cretion, would be productive of much benefit. 
But unfortunately this is not always the case. 
In practice we find it more generally exhibited in 
the habit of continuing to eat after the appetite 
has been satisfied, than in restraining self-indul- 
gence before that point has been reached. The 
consequence is, that habitual repletion is an evil 
constantly met with, and productive of the most 
serious injury to those who are guilty of it. But 
though pernicious under all circumstances, it 



OF DISEASE. 125 

becomes infinitely more so if practised when the 
ordinary powers of digestion are suspended, as in 
fever. At such a time the mere absence of appe- 
tite would be no sufficient safeguard for the pre- 
servation of the patient. It requires a stronger 
and more effectual restraint upon a habit that is 
so generally practised, and such a restraint is 
effectually provided in the symptom under con- 
sideration. Can we doubt for a moment that the 
existence of the symptom is really the result of 
design? or that the intention of its appointment 
is as beneficent as it is wise. 

Under this head we may conveniently consider 
a class of symptoms varying in different diseases 
according to the nature of the disorder, but 
agreeing in this, that they occur at the com- 
mencement of the attack, and serve the useful 
purpose of suggesting to the observant medical 
attendant the proper mode of treatment to be 
adopted. Thus, vomiting is not an unusual symp- 
tom at the commencement of an attack of inflam- 
mation of the lungs; and a plan of treatment 
which, when adopted sufficiently early, is found 
to possess peculiar advantage in that complaint, 
consists in the administration of medicines which 
have an emetic property. Similarly many cases 
of diarrhoea require for their successful manage- 
ment the employment of mild aperients. In these 
cases nature appears to point out spontaneously 
11* 



126 VARIOUS SYMPTOMS 

the proper course to be adopted. It may be thought 
that the admission of the existence of such a prin- 
ciple necessarily countenances the doctrine recently 
propounded by Hahneman and his disciples, who 
are accustomed to administer in every form of dis- 
ease the medicines which have a natural tendency 
to produce a similar action. But a little reflection 
will suffice to show that the two propositions are 
widely different. What is here contended for is, 
that in the group of symptoms which show them- 
selves at the commencement of an attack of 
illness it is sometimes possible to select some one 
in particular which shall enable us to determine 
on a plan of treatment likely to be beneficial. 
That symptom may, as in the instances just re- 
ferred to, lead us to administer medicines which 
possess the property of producing similar effects, 
or it may have nothing to do with it. Thus, the 
contracted pupil of a person suffering under inflam- 
mation of the eye, does not lead us to administer 
medicines which have the property of stimulating 
the iris to contract, but simply to act upon the 
suggestion that nature is silently but most signi- 
ficantly making, to exclude the light from the too 
sensitive nerve of vision. Hahneman's theory, 
on the contrary, is, that when there exists a 
morbid action of a particular kind, its true remedy 
will be found in the use of a medicine capable of 
producing a similar action in a person in health. 



OF DISEASE. 127 

Hence, lie prescribes nauseating drugs to tran- 
quillize an irritable stomach, and opium to re- 
move an attack of apoplexy. To his views, as 
thus expressed, many objections may be stated. 
They seem to depend on a misconception of what 
may be considered a medical axiom, "similia 
similibus curantur" the true interpretation of 
which is, that whenever two cases resemble each 
other in their nature and symptoms, the remedies 
which have been proved to be useful in one of 
them will be suitable in the other ; but which he 
understands to mean, that remedies which are 
similar in their mode of action to the diseases for 
which they are prescribed, are more appropriate 
than those which are dissimilar. But not to dwell 
on this subject farther, it is sufficient to observe, 
that, even in the sense here employed, it is not 
possible to discover the suggestive symptoms of 
which we speak in every case; many maladies 
being met with, which afford us no clue in their 
external appearances to a rational and intelligible 
mode of treatment. Shall we then deny that any 
useful purpose is intended by the symptoms under 
consideration? Shall we infer that their occur- 
rence in any particular malady is purely the re- 
sult of accident, because we do not discover them 
in every form of illness ? or shall we rather admit, 
that their existence in any particular instance is 
the result of an intelligent forethought, seeing 



128 VARIOUS SYMPTOMS 

that their utility is so great, and that their ab- 
sence, when they are wanting, is compensated for, 
as experience amply proves, in other ways equally 
useful. 

Fainting is an event of every-day occurrence. 
It is not, as most persons must be aware, of any 
material danger to the individual, though its 
appearances are sufficiently alarming to the spec- 
tators ; yet this freedom from danger is not due 
so much to the nature of the attack as to the 
circumstance, that it necessarily leads to a change 
in the posture of the patient, which removes for 
the time the condition upon which the fit de- 
pended. In this change of posture then we 
discover another provision of a salutary kind, 
such as we have been considering. An attack 
of fainting may occur under a variety of circum- 
stances. It may originate in loss of blood, as 
from a wound ; or it may arise from a deteriorated 
condition of that fluid, as from a want of proper 
nourishment; or it may depend upon irregular 
action of the nervous system, as in the com- 
mencement of fever. In all cases, however, what- 
ever may be the remote cause of the production, 
there is present a certain change in the vascu- 
lar condition of the brain. This important organ 
is enclosed, as every one knows, in the cranium, a 
thick, bony case, which not only protects it from 
injury, but also equalizes the degree of com- 



OF DISEASE. 129 

pression to which it is continually subject. Any 
considerable augmentation or diminution in this 
pressure would be attended with pernicious con- 
sequences to the delicate structure of which it 
is composed. Hence the physical conditions in 
which it is placed are admirably adapted to 
prevent any material alteration in this respect. 
Some modern writers, it is true — among whom 
may be mentioned the late excellent Doctor 
Abercrombie — have doubted the correctness of 
this view, and have been led to deny the pos- 
sibility of altering the amount of vascular com- 
pression of the brain at all, maintaining that the 
symptoms which are usually attributed to this 
source are really due to a variation in the relative 
quantities of the arterial and venous currents. 
But more recent observations, and especially a 
series of experiments, instituted for the purpose 
of determining the question, and admirably con- 
ducted by Doctor Burrowes, leave no reasonable 
room for doubt upon the mind, that within certain 
limits, narrow indeed, but still distinct, the quan- 
tity of fluid circulating within the skull is capable 
of being increased and diminished. Now, this 
being admitted, it is to be observed, that an 
attack of fainting comes on when the pressure is 
diminished by a reduction in the quantity of 
blood circulating in the skull. It is thus that 
hemorrhage induces its occurrence. As soon, 



130 VARIOUS SYMPTOMS 

however, as this state has actually been brought 
about, an immediate relaxation of the whole 
muscular system is the consequence : the patient 
loses his consciousness, the nervous energy is 
destroyed, and the patient falls down insensible 
to the ground. In this very result all his safety 
consists. So long as the patient preserves the 
erect posture, it must be obvious that the force 
of gravity acting upon the columns of blood that 
extend upwards to the head, must have the effect 
of diminishing the quantity within the skull, and 
so perpetuate the evil under which the individual 
is suffering ; and if this state were to be pro- 
tracted for a few moments the consequences 
would be extremely dangerous, or even fatal. 
But as soon as the sick man falls down, the 
change of posture at once removes the force 
of gravity, and allows the fluids to return to that 
state of distribution which is necessary for the 
maintenance of the healthy functions of the brain. 
Some forms of the affection depend really upon 
the action of the heart, though the brain is like- 
wise in a subordinate way concerned in their 
production. In these cases the quantity of blood 
circulating in the system may be sufficient in 
amount, but from its altered qualities it does not 
stimulate the heart adequately, so as to enable it 
to propel its contents with the force necessary to 
supply the brain as it ought to do. This is the 



OF DISEASE. 131 

form of the complaint that is so commonly met 
with in young females. The heart is one of the 
most remarkable organs in the body : it possesses 
to a certain extent an independent power of 
action ; so much so, that if cut out of an animal 
immediately after being killed, it would continue 
for a considerable time to contract in the same 
manner it did previously, even though empty of 
blood, and lying on the table. But these mus- 
cular contractions gradually become weaker, not 
only because of the separation of the organ from 
the rest of the living structure, but still more so 
from the want of their natural stimulus — the 
blood. It is the current of this fluid distending 
its cavities at regular intervals during life that 
principally determines its movements. When it is 
well filled with a large quantity of rich blood, its 
contractions are strong and energetic. When, on 
the contrary, it is but partially filled, or when the 
blood is of inferior quality, its contractions are 
feeble and inefficient. Under the latter circum- 
stances it is less able to propel the current 
upwards to the head against the force of gravity, 
and fainting is not an uncommon result. But let 
the patient be laid down, and the difficulty is 
removed : the heart, relieved of the physical dis- 
advantages under which it had been placed, is 
enabled to transmit the required quantity to the 
sensorium with due regularity, and the equilibrium 



132 VARIOUS SYMPTOMS 

of the circulation is immediately restored. It 
is scarcely necessary to observe, that cases of 
this kind are frequently mismanaged by persons 
ignorant of the proper treatment. Disliking to 
see any one stretched upon the floor, particularly 
if it be a delicate and respectable female, they 
begin at once to raise her up into a sitting 
attitude, to the manifest disturbance of that 
process that nature, in her own quiet way, is 
taking for her recovery. Is it right, considering 
the useful consequences that result from the occur- 
rence, to look upon the fall of the patient in these 
cases as an accidental circumstance, and not rather 
to regard it as a wise appointment on the part of 
the Author of sickness, designed for the best and 
most beneficent purposes ? 

Sudden hemorrhage, whether it be the result 
of accident or disease, is often attended with 
the most alarming and even fatal consequences. 
Unless speedily restrained in some way, it is 
needless to observe, that the loss of so important 
a fluid would be followed by immediate death. 
But the exigency of the moment is provided 
with a remedy suited to the occasion. And in 
considering the provision it is difficult to deter- 
mine whether we ought most to admire the 
beauty of the contrivance, or the simplicity of 
the means employed to effect it. To understand 
it perfectly we must remark, that the great func- 



OF DISEASE. 133 

tion of the circulation is carried on in a series of 
tubes of varying size, and of a strength pro- 
portioned to their respective diameters. These 
are not unyielding pipes, such as we are accus- 
tomed to see used for conveying water in our 
streets, but consist of elastic materials similar to 
the Indian-rubber tubing, which has lately been 
brought into such general use. The consequence 
is, that they accommodate themselves easily to 
the varying quantity of fluid they happen to con- 
vey, and so are less liable to rupture than they 
would otherwise be. In this way the very 
loss of blood, when it occurs, is of itself a check 
upon its continuance, because, as the tube itself 
is elastic, the contraction of its diameter, which 
is the consequence of its diminished contents, 
closes the aperture at which the leakage occurs 
until a fresh formation of blood has taken place 
to such an amount as to distend the vessel to its 
original size ; but as this requires an interval of 
time directly proportioned to the degree of 
the hemorrhage, a sufficient period necessarily 
elapses to allow of the repair of the damage, so 
as to prevent a recurrence of the accident. If to 
this is added the fact of its inducing an attack of 
syncope, which may be considered a distinct hint 
as to the propriety of maintaining the hori- 
zontal position, we shall see that the arrange- 
ments which are thus provided by nature for our 
12 



134 VARIOUS SYMPTOMS 

recovery, are admirable in the extreme. Any 
excitement of the circulation at such a time would 
be attended with the greatest risk. The recum- 
bent posture, by relieving the heart of the prin- 
cipal part of its duty, necessarily tends to tran- 
quillize its motions, while the erect attitude has 
an effect exactly the reverse. It is true that, 
no matter what posture the patient happens to 
assume, the heart's action, after great loss of 
blood, appears to exhibit unusual violence, the 
pulse under the finger becoming not only fre- 
quent but thrilling ; but this characteristic, which 
is so constantly observed, as to have got the 
special name of a "hemorrhagic pulse," is really 
deceptive, and indicates weakness rather than 
force. It depends upon the necessity that is 
imposed upon the organ to compensate, in some 
measure, for its loss of power, by increased 
efforts of propulsion; and it is most effectually 
relieved by making the patient observe the simple 
expedient of lying in bed during its continu- 
ance. In these two things — the development 
of syncope, and the contraction of the coats of 
the elastic tubes — we have a complete provision 
to guard against the danger of hemorrhage — a 
provision that comes into play exactly at the 
moment when the necessity for its protection 
arises. The greater the loss of blood, the more 
fully is it exhibited. Can it be supposed that an 



OF DISEASE. 135 

arrangement so salutary and so beautiful, is 
any thing else but the result of an intelligent and 
kind contrivance? 

The last instance to which we shall direct 
attention at this time, is the occurrence of strain- 
ing of the stomach, or actual vomiting, in what is 
commonly called a fit of a gall-stone. This, which 
consists in the passage of a biliary calculus 
through a narrow duct, though a circumstance of 
comparative rarity, is almost always a matter 
of considerable annoyance to the patient. The 
smallness of the channel through which it has to 
pass, and the spasm of the textures to which it 
gives rise, are sufficient to explain the suffering it 
occasions. The violence of the pain which is 
thus induced, and which is often so great as to 
amount to actual agony, is frequently relieved 
in a most sudden and surprising manner by the 
mere effort of straining, whether brought on by 
artificial interference, or the natural result of the 
condition of the parts. To understand the mode 
in which this symptom acts, it is necessary to be 
acquainted, in some measure, with the structure 
or functions of this part of the digestive appa- 
ratus. The bile is one of the most elaborated 
juices of the body, and as it cannot be secreted 
with sufficient rapidity to admit of its being 
supplied in large quantity at the moment it is 
required, a provision exists for its being stored, 



136 VARIOUS SYMPTOMS 

according as it is prepared, in a small bag on the 
under surface of the liver, where it is retained 
until the period when the process of digestion has 
commenced, at which time so much of it is poured 
out as may be necessary for the wants of the mo- 
ment. This store-bag is about the size and shape 
of an ordinary pear, with a long and narrow tube 
leading into the lower portion of the stomach, 
through which the fluid is conveyed as often as 
may be requisite. The presence of food in that 
part of the stomach where the aperture of the duct 
is situated, acts as a stimulus to the contractile 
coats of the gall-bladder to push forward their 
contents; so that the passage of the bile takes 
place principally, if not exclusively, at those 
periods when the stomach is distended with food. 
The formation of calculi, which frequently con- 
sist merely of inspissated bile, though they do 
occasionally contain other elements, is accounted 
for by the fact of the bile having often to lie 
for a considerable period in the gall-bladder, 
especially in persons who fast for an unusually 
long period, where the watery portion becomes 
absorbed, and the more solid matters become 
hardened. These calculi, whatever the consti- 
tuents they contain, are productive of no incon- 
venience, so long as they remain quietly in the 
large extremity of the bag, as they often do for 
years together; but whenever they are pushed 



OF DISEASE. 137 

forward towards the duct, they become the 
immediate cause of exquisite suffering. This is 
especially apt to occur during the taking of a 
large meal, or shortly after, because the exigen- 
cies of the occasion call for an unusually large 
supply of bile, and the contractions of the vessel 
in which it is contained are proportionally great. 
The difficulty of propelling a solid body through 
a duct of such narrow dimensions, is still further 
increased by the existence of structural impedi- 
ments, designed to prevent the regurgitation of 
the fluids of the stomach up into the gall-bladder. 
These impediments are two-fold — one a spiral 
valve, consisting of a layer of mucous mem- 
brane projecting into the interior, and coiled 
regularly round the inside ; the other depends 
upon the mode in which the duct enters into the 
stomach: this is not, as might be supposed, 
a short direct passage, but a long and con- 
tinuous course, penetrating between the muscular 
fibres of the coats of the stomach, the contrac- 
tion of which serves to keep the aperture closed 
against the entrance of foreign substances, though 
it permits the free escape of the bile. But these 
circumstances, sufficient as we may think them 
to prevent the passage of a gall-stone through 
the duct, are not the only impediments it has to 
meet in getting into the stomach, nor even, it 
may be said, the principal ones ; neither are they 
12* 



138 VARIOUS SYMPTOMS 

the source of the patient's suffering. Such is 
the power of dilatation that hollow organs possess, 
that a little time is all that would be requisite 
to enable them to expand sufficiently to allow 
of calculi of considerable dimensions passing 
through them. No: the principal difficulty, as 
well as the principal source of suffering, consists 
in the spasmodic contraction of the muscular 
fibres of which the duct is composed, and which 
are here, as in all other hollow viscera, dis- 
posed in a circular manner, so that when they 
act they restrict still further the space through 
which the body has to pass, and hold it as in 
a vice, so that it can neither recede nor advance. 
But just at this crisis, owing to a particular 
arrangement, which it is not necessary further to 
allude to, the patient is commonly seized with an 
involuntary effort of vomiting or straining, which 
is frequently the means of removing the fit 
entirely, and restoring the patient, for a time at 
least, to perfect ease. This depends upon that 
universal relaxation of the muscular system, that 
everybody knows, who has ever experienced sea- 
sickness, invariably attends the forcible empty- 
ing of the contents of the stomach ; and that, 
extending to the minute fibres of the gall-duct, 
unlocks the grasp in which the calculus is held, 
and allows it to slip back into its former position 
at the large end of the gall-bladder. 



OF DISEASE. 139 

It is scarcely necessary to multiply examples of 
this class, all of which, when carefully examined, 
would only tend to establish the same great and 
important truth: that, even in the midst of the 
most severe and destructive processes, provisions 
can be detected to mitigate their severity, which 
can have been implanted there only by One intel- 
ligent enough to appreciate their danger, and to 
discover the most suitable methods of averting 
it, and good enough to furnish, in the simplest 
and securest manner, what His wisdom had pro- 
nounced to be necessary. 



140 PROCESSES 



CHAPTER VIII. 

OF PROCESSES OF A PRESERVATIVE CHARACTER 
OCCURRING IN DISEASE. 

The examples which have been given in the 
last chapter, are all the direct result of the ordi- 
nary operations of the vital forces, and not of any 
new or unusual mode of action, induced in them 
by disease : in other words, they are instances of 
physiological, rather than of pathological action; 
and in this respect may seem open to the objec- 
tion, that they do not contain any distinct evidence 
of a salutary interference for the purpose of re- 
storing the system to a healthy state, such as is 
necessary to establish the idea of design. But 
this objection is not really entitled to the slightest 
attention. It is, as has been already remarked, 
the glory of God to exhibit in His works the 
greatest simplicity of means, with the greatest 
complexity of results ; in this, as in every thing 
else, drawing a strong contrast between the ease 
and beauty of His arrangements, and the clumsy 
mechanism of human contrivance. He delights to 
make one cause accomplish many objects, and He 



OF PRESERVATION. 141 

never stoops to employ a second unless He sees 
it to be absolutely necessary. That the arrange- 
ments in question are the result of a deliberate 
intention on the part of God, and not a mere 
casual coincidence, occurring without motive, is 
evident, not merely from their exhibiting the 
characters of utility and benevolence, which it is 
irrational to suppose any mere accident can pos- 
sess, but still more from their number and variety. 
It is possible to believe that a single event, how- 
ever surprising, may occur once upon an occasion 
by a fortuitous combination of causes; but it is 
absurd to imagine that such things can happen 
regularly, and can happen frequently, and still 
exhibit the same marvellous property of answering 
a useful purpose. The fact of intention being 
established in reference to their occurrence, it is 
a matter of very little consequence to the argu- 
ment, whether their production is due to the 
operation of causes unconnected with the morbid 
influence, or of others which result from it. In 
both cases they are equally the work of God, and 
in both they have an equal claim upon our admi- 
ration. Nor does it make the slightest difference 
in our view, whether we consider the physiologi- 
cal properties of the organism to have been origi- 
nally framed with a special reference to the patho- 
logical necessities that should subsequently arise, 
or whether we adopt the opposite view, that the 



142 PROCESSES 

physiological properties having been first estab- 
lished, the pathological arrangements were sub- 
sequently framed with a special reference to the 
former. In other words, whether we believe that 
God, foreseeing the fall of Adam, framed the struc- 
ture of his body with a special reference to the 
necessities of disease that should subsequently 
be developed; or whether we maintain, as some 
are inclined to do, that the circumstances of dis- 
ease, such as they now exist, were arranged in 
consequence of the organization that had been 
previously conferred upon the body. The first of 
these opinions unquestionably exalts the Divine 
omniscience, and the perfection of His attributes 
more highly than the latter; but both of them 
equally refer the production of the provisions we 
have been considering, to the direct appointment 
of God, and convert the objection that has been 
started into a ground for still more deeply admir- 
ing the wisdom and goodness of His character. 

But whether there be really any force in the 
objection, as applied to the instances formerly 
adduced or not, it is important to observe, that it 
cannot apply in the slightest degree to the cases 
that are to follow. In these we shall be able to 
trace a distinct departure from the ordinary ope- 
ration of the vital forces, such as proves that a 
new and unusual influence is brought to bear upon 
them when affected by disease, for the sole purpose 



OF PRESERVATION. 143 

of moderating the violence of its action, and guard- 
ing against certain contingent dangers that would 
otherwise arise. The first illustration I shall adduce, 
refers to the different effects produced by inflamma- 
tory action on the mucous and serous membranes. 
It might naturally be expected, that the same 
morbid action affecting these textures, would 
produce nearly similar results. But this is not 
the case ; a marked and most important difference 
is observable. It is necessary to mention, that 
these two classes of membranes differ remarkably 
in their structure and uses. The serous mem- 
branes, as has been already mentioned, are 
extremely thin transparent textures, perfectly des- 
titute of blood-vessels, and smooth on their unat- 
tached surface. In every direction they are closed 
up, so as to form a shut sac, and the design of their 
formation is, to diminish the friction of the adjacent 
structures in their movements upon c_.e another. 
The mucous membranes, on the contrary, are 
tolerably thick, highly vascular, and of a soft velvety 
texture. They are open at one or both ends, 
when they are in contact with the external sur- 
face ; and the use that they are intended to serve 
is, to line the great channels of internal communi- 
cation, and to permit the passage along their 
surface of the air, in respiration, and of the ma- 
terials of nutrition. Now, the difference in the 
effects of inflammation, as applied to these -two 



144 PROCESSES 

classes of membranes, has reference to the parti- 
cular ends that were contemplated in their 
formation, so that this process, which is so easily 
induced, and so perpetually occurring, might be 
productive of as little permanent injury as possible. 
The difference is this, when inflammation attacks 
a serous membrane, there is immediately poured 
out upon its free surface a quantity of an opaque 
white matter, called lymph, which has the pro- 
perty of gluing together the parts with which it 
comes in contact; whereas, when it attacks a 
mucous membrane, no such phenomena is per- 
ceived, but either purulent matter is formed upon 
the surface, or a number of round holes are exca- 
vated downwards towards the adjacent organs: 
that is to say, in the one case we have the adhe- 
sive, and in the other the suppurative, form of 
inflammation. This difference in the result of the 
process does not depend, as might at first thought 
be supposed, upon the difference of the structures, 
or upon an inherent incapability upon the part of 
the mucous membranes to take upon them the 
adhesive inflammation, or of serous membranes 
the ulcerative ; because we do occasionally, though 
rarely, find these results occurring. No ; it depends 
entirely upon a special appointment for the pur- 
pose of preventing evils which would be altogether 
incompatible with the continuance of life. If the 
mucous membrane were ordinarily to assume the 



OF PRESERVATION. 145 

adhesive form of inflammation, the apertures for 
breathing, on every attack of cold, would run the 
risk of being stopped up ; or if it attacked the 
alimentary canal, the patient would be in danger 
of being starved to death, by the passage being 
converted into an impervious cord. Similarly, if 
the serous membranes were to assume the ulce- 
rative form, consequences equally disastrous would 
follow. The integrity of the peritoneum, for 
example, would be destroyed, and the contents of 
the stomach would find their way into a situation, 
where they would no longer be capable of under- 
going digestion, but where they would be produc- 
tive of the greatest inconvenience. Or if it were 
the pleura that happened to be engaged, the 
atmospheric air, instead of being confined to the 
lungs, would make its escape into the cavity of 
the thorax, where its presence would interfere 
mechanically with the movements of the chest, 
and produce embarrassment, if not absolute suf- 
focation. All this, and many other evils of a 
similar description, are effectually guarded against 
by the simple circumstance under consideration — 
a circumstance, as we have stated, not depend- 
ing upon a difference in the structure of the parts, 
but upon a difference in the mode of action, im- 
posed upon the vital forces to meet the special 
exigencies of the occasion. 
In the mode by which purulent matter is 
13 



146 PROCESSES 

eliminated from the system after its formation, 
we have another example of a peculiar impres- 
sion being made upon the vital forces to regulate 
their action for the accomplishment of a useful 
purpose. This fluid is secreted under two dis- 
tinct conditions — either on the free surface of 
the mucous membranes, or in the cavity of an 
abscess. There is nothing particularly deserving 
of attention in the first of these, because the 
open communication that exists with the external 
air admits of the matter being carried off at each 
moment as rapidly as it is formed. But when it 
occurs among the deeper seated textures, as in 
the second form, there is requisite a special 
provision for its removal, otherwise it would 
remain permanently fixed in the place where 
it is first formed, because, to guard against 
other dangers, it is not left loosely scattered among 
the muscles, &c, but securely invested in a mem- 
brane formed for the occasion. Were it not for 
this, it would be taken up by the absorbents, and 
carried into the current of the circulation, where 
it would contaminate the blood until it poisoned 
all the organs of the body, or it would escape 
into the surrounding tissues, and propagate in its 
course the inflammation still further : each par- 
ticle, as it advanced, becoming the source of fresh 
irritation, and, consequently, of increased danger. 
All this actually happens in a few rare cases, 



OF PRESERVATION. 147 

when the constitution does not possess sufficient 
vigour to form an investing membrane for the 
abscess, and which, consequently, have been 
denominated "diffuse inflammation" — one of the 
most fatal forms of this process with which we 
are acquainted. But let us suppose that the 
matter deeply seated in some of the internal 
parts of the body is carefully sealed up in this 
living case — as it will answer no useful end to 
permit it to remain there — how is it to be got 
rid of? It is evident that unless some special 
provision were made for its removal, it could 
never escape from its confinement without being 
productive of injury, more especially when we 
remember the number of vessels and nerves it 
must necessarily come in contact with; yet all 
this is very effectually secured. The whole ab- 
scess is gradually transplanted from its original 
situation to the surface of the body, by a process 
called interstitial absorption, in which nature 
takes care to clear the ground she evacuates, at 
the same time that she extends the lines of her 
entrenchments in front. In this course the nerves 
and blood-vessels are either pushed aside, or so 
invested with a protecting membrane as to be 
defended from all danger. When arrived at the 
surface the contents are discharged in the manner 
with which every one must be familiar, and which, 
equally with the rest of the proceeding, exem- 



148 PROCESSES 

plifies caution and care. We have said the 
direction the abscess pursues in this course is 
towards the surface of the body ; but this, though 
the usual, is not the universal direction. Occa- 
sionally the matter proceeds inwards towards 
one or other of the mucous membranes, and 
especially towards that lining the alimentary 
canal, because, when the abscess discharges 
itself there, it can easily be carried downwards 
through the channel provided for its reception. 
But the former is the rule — the latter the rare 
exception in these cases ; and the reason of the 
difference in frequency between the courses 
seems to be, that it is a much easier matter to 
heal an opening of this description on the surface 
of the body than on one of the mucous mem- 
branes. The latter are invariably connected 
with a layer of muscular fibres, whose natural 
action must stretch, more or less, at every 
moment of their being called into exercise, the 
texture that is attached to them : added to which 
the various substances that traverse these hollow 
tubes must irritate the ulcer, and interrupt the 
process of cure. The consequence is, that, to 
prevent the occurrence of these inconveniences, 
abscesses, even when seated close to the mucous 
membranes in some deep situation, almost imme- 
diately prefer a long circuitous course to the 
surface, to a short and direct passage in the other 



OF PRESERVATION. 149 

direction. Can we doubt that a fact which is 
established by the daily experience of every 
medical man of observation, and which is univer- 
sally admitted, is really a pathological law estab- 
lished for the very purpose of guarding against 
the dangers we have mentioned. 

We may take another example of the same 
important principle from the history of acute 
hydrocephalus, or, as it is popularly termed, 
"water on the brain. " This, as is universally 
known, is a disease peculiarly affecting infancy, 
depending partly on the state of the constitution 
of the persons attacked, and partly on the manner 
in which the growth of the parts of the body 
is regulated at that period of life. The former is 
probably connected with the consistence of the 
blood in such persons, which is thinner than that 
of healthy individuals, and so more prone to 
escape through the sides of the vessel than 
if it were richer. The mode of growth operates 
in this way : — In the first years of existence the 
energy of development seems to be principally 
directed to the head and nervous system, and, 
as a necessary consequence, the quantity and 
impetus of the blood circulating in these parts 
are relatively greater than in the rest of the body. 
The vessels of the brain are thus kept in a state 
of unusual tension at the very time when there 
is the greatest liability to exhalation taking 
13* 



150 PROCESSES 

place. Now, in accordance with what has for- 
merly been advanced of the inability of the brain 
to bear any unusual increase in the pressure to 
which it is subject, it is clear that great mischiefs 
would arise from this state of things were there 
not some provision introduced to mitigate their 
severity. In fact, it may be confidently asserted 
that, fatal as the disease actually is, it would be 
much more so, and much more rapid in its pro- 
gress, were it not for the circumstance, that the 
cranium does not at that period of life consist 
of one unyielding mass of bone, as it does in 
the adult, but of several distinct pieces united 
together by membranes, capable of a certain 
degree of extension, and which yield under the 
pressure to which they are exposed, so as to 
relieve the brain. It is true that the formation 
of the head in this way has a primary reference to 
the mode in which the child is brought into the 
world, which requires that the head should be, 
as it were, folded up for the time into an unu- 
sually small compass ; but what proves that the 
view here given is also founded in truth is, that 
while the ossification of the skull proceeds with 
comparative rapidity in those children who are 
not predisposed to the disease, it is delayed to a 
later period in those who are, so that the pro- 
vision exists precisely in those circumstances where 
its advantages are most required. 



OF PRESERVATION. 151 

In the usual progress of pulmonary consump- 
tion we shall be able to discover several provi- 
sions of a similar kind, and which are particularly- 
deserving of attentive consideration. It is hardly 
necessary to remark that this disease is one of 
the most frequent and fatal affections that the 
human frame is liable to ; but its tendency to 
develope new and sudden dangers is very mate- 
rially diminished by the circumstances to which 
we are about to allude. It is tolerably well 
known that the essential feature of the complaint 
consists in the deposite of a morbid product in the 
lungs called " tubercle/' which has no analogy 
with any of the constituent elements of the body. 
The formation of this substance seems to depend 
upon a defect in the powers of assimilation, which, 
in consequence of inherent or acquired debility, 
fail to produce out of the materials of the food 
a chyle of the proper character. The imperfect 
chyle thus generated and introduced into the 
circulation is carried along with the rest of the 
blood to the lungs, where, by virtue of the 
depurating property they possess, an attempt is 
made to separate the unhealthy elements from 
the rest, and so to counteract the mischief they 
are calculated to produce. Were this organic 
effort attended with success almost all the pecu- 
liar features of this formidable complaint would 
be arrested. The patient, it is true, might suffer 



152 PROCESSES 

emaciation and weakness in consequence of the 
imperfect nutrition taking place in the digestive 
system, but all the symptoms depending upon 
organic changes in the structure of the lungs would 
be obviated. As it is, there is reason to believe 
that the state of the constitution, upon which the 
formation of tubercle primarily depends, exists for 
a considerable time previous to the development 
of the symptoms that are supposed peculiarly 
to mark the commencement of the complaint; 
but the matter being formed at first in small 
quantities only is carried off as rapidly as it 
is generated by the provision to which we allude, 
and which consists in the circumstance of its 
being thrown out upon the free surface of the 
pulmonary mucous membrane. It was for a long 
time a disputed point in morbid anatomy to 
determine what is the precise seat occupied by 
the matter of tubercle in the lungs; but the 
researches of Doctor Carswell have at last set 
the matter at rest, and it is now universally 
admitted, that it is thrown out upon the free 
surface of the air cells and bronchial mucous 
membrane. At first it exists in fluid form, but 
exposure to the air in respiration dries and 
hardens it, so that, collecting in successive layers, 
it finally assumes the shape of the mould in 
which it happens to be placed, and this being 
usually the globular extremities of the air 



OF PRESERVATION. 153 

channels, it is presented to the eye of the patho- 
logist in a spherical form. Two circumstances 
corroborate the correctness of this opinion of 
Carswell's, and at the same time show the utility of 
the arrangement which determines the deposition 
of the product on the free surface of the mucous 
membrane. The first is, that the place where tuber- 
cular matter is first detected in incipient cases of 
consumption, is invariably the apex of the lungs. 
This arises from the limited motions that the 
upper part of the chest possesses, when compared 
with the lower, as any one who will take the 
trouble of examining the ribs during ordinary 
respiration can easily discover. It is plain that 
if the tubercle be thrown upon the air passages 
it will more certainly and more speedily be 
carried off* from those portions which have the 
greatest and most continuous motions. The 
second fact is, that while tubercular matter is 
formed in animals of very different modes of life, 
the situation, where it is deposited in each, is 
influenced in a very remarkable manner by the 
habits of the animal. Thus in animals of seden- 
tary habits, who take little active exercise, it 
will be found to accumulate in the lungs because 
the slowness of their movements does not suffi- 
ciently excite these organs to enable them to dis- 
charge the unhealthy deposit e as fast as it is 
formed. This is remarkably the case with cows, 



154 PROCESSES 

a class of animals that, when kept in large towns, 
are extremely prone to this peculiar complaint. 
But in animals of an opposite description — mon- 
keys for example, who take much exercise of 
a violent description, we do not find the tubercle 
in the lungs, though it is an extremely common 
product in such of them as are brought to these 
countries, but in the spleen and liver. The same 
idea is confirmed by a comparative examination of 
the situation of tubercle in children and in adults. 
In the latter, as most persons are aware, it is 
found almost always in the lungs, to the exclu- 
sion of other organs ; but in the former, though 
it is still constantly met with in the lungs, yet it 
is frequently found in the liver and spleen as 
well. The explanation of these facts is to be 
found in the different degrees of active exercise 
taken by the child and the adult. Let us suppose 
that there is an inherent tendency in the economy, 
to throw out the tubercular matter, whenever it is 
generated in the system upon the pulmonary mu- 
cous membrane, it will follow as a necessary con- 
sequence, that the more full and forcible the 
movements of respiration happen to be, the more 
perfect will be the elimination of the morbid pro- 
duct. And were it not that the spleen and liver 
at such times become congested, owing to the 
unequal distribution of the circulating fluids, 
whereby the crude particles floating in the blood, 



OF PRESERVATION. 155 

become entangled in the minute cells of their 
structure, so as to accumulate into irregular masses, 
there is every reason to believe that the whole would 
be safely and completely removed from the system. 
Can we hesitate to admit that the law which regu- 
lates the deposition of this morbid product in that 
part of the body which is best fitted to carry it 
off safely, has been determined with a special 
reference to this very object ? 

But this is not the only example of the same 
beneficent care that occurs in consumption. The 
tubercular deposit, hardening as it accumulates, 
increases in volume, and gradually presses on the 
surrounding structures, so as to be a source of 
irritation which eventually leads to the formation 
of ulcers, or large vomicae, involving the destruction 
of considerable portions of the pulmonary tissue. 
Such a result must be fraught with the highest 
danger to organs constituted as the lungs neces- 
sarily are. Formed for the purpose of depurating 
the blood by the simple process of exposure to the 
air, it must be evident that this vital fluid is con- 
tained in vessels of the thinnest description, to 
admit of the atmosphere taking effect through 
their parietes, and that the lungs must consist 
essentially of one enormous mass of blood-vessels. 
Is it possible, then, that any considerable extent 
of their spongy texture can be removed by ulcera- 
tion without the patient dying of hemorrhage? 



156 PROCESSES 

Happily for mankind, such an accident is ex- 
tremely rare. Were it otherwise, this complaint, 
which is so terrific, from the number of its victims, 
would become still more so from the frightful 
rapidity with which it would hurry them to their 
graves. The way in which this is guarded against 
is this. Whenever the matter accumulates in any 
part to such a degree as to cause pressure on the 
adjacent tissues, the arteries that convey the blood 
in that direction become sealed up, and ultimately 
converted into a solid fibrous cord, so that no 
more blood can be carried through them. This 
is effected by means of the sides of the vessel 
being forced together by the hardened tubercle, 
inflammation within the vessel being set up, and 
the opposite sides being glued together. It is for 
this reason that, when pathologists attempt to 
inject coloured size into lungs that have been 
attacked by consumption, they find it impossible 
to force it in the slightest degree beyond the limits 
of the healthy portion. 

But there is another accident connected with 
consumption which is liable to occur, and which, 
though distressing enough when it does happen, 
is comparatively rare, because provisions exist to 
guard against its development; and that is rup- 
ture of the pleura. This is the delicate membrane 
that lines the inside of the chest, so as to enable 
the play of respiration to take place easily in the 



OF PRESERVATION. 157 

alternate expansion and contraction of the thorax. 
It is by means of this membrane that the lungs 
are kept applied in the closest manner to the 
opposite walls of the chest, while they are enabled 
to accommodate themselves readily to the dif- 
ferent degrees of expansion that may be employed 
in the voluntary efforts of the individual. Indeed it 
may be said, that it is through means of the pleura 
that respiration takes place at all. Being a closed 
air-tight sac, as soon as the powerful muscles 
which elevate the ribs begin to act, a vacuum 
would be formed in the interior were not the 
lungs immediately to swell out and fill up the 
room thus left in the cavity of the thorax. But 
whenever this membrane is ruptured, and air gets 
admitted into the interior, the beauty of this 
mechanism is destroyed, and the lungs are no 
longer placed in the same favourable circum- 
stances for expansion that they were before : so 
that they remain flaccid and motionless. Indeed 
a more unpleasant effect is sometimes produced 
after such an accident than the mere loss of 
motion, and that is the rapid distension of the side 
with air, so as to compress the lung of one side 
entirely, and to destroy its whole power of acting. 
This is produced by the air enjoying a free en- 
trance into the cavity of the pleura at each effort 
of inspiration, while the pressure of the ribs upon 
the contained air forces the aperture to close, and 
14 



158 PROCESSES 

prevents its escape, so that the quantity con- 
tained in the thorax continually increases with 
each respiratory movement to the manifest incon- 
venience of the patient, and to the great risk of 
instant suffocation. Yet even for this we find a 
suitable precaution provided, and that is the 
gradual formation of a thick layer of lymph, 
covering the entire upper part of the lungs, where 
the deposite of tubercle is most commonly observed, 
and where, were it not for this, the progressive 
ulceration would be most likely to cause the acci- 
dent to take place. Is it a casual circumstance 
that determines the formation of this protecting 
cap, in the very situation, and in the very disease, 
where its assistance is most required ? 

When ulcers form within the stomach, as they 
sometimes do, the consequences are often most 
deplorable; the patient dying suddenly from the 
escape of food into the peritoneum, or from the 
ulcer corroding some of the arteries that invest 
the stomach, and so producing fatal hemorrhage. 
These accidents, even when threatened by the 
formation of the ulcer, are to a considerable extent 
guarded against by the morbid process producing 
an unusual thickness in the coats of the digestive 
tube at the part, and an adhesion taking place be- 
tween the part where the ulcer is seated and the 
adjoining viscera. Thus, it is not unusual to find the 
stomach firmly glued to the liver at the spot where 



OF PRESERVATION. 159 

ulceration lias occurred, so that the bottom of the 
ulcer is formed by the surface of the gland, and 
no escape of the contents of the stomach can take 
place into the peritoneum in consequence of the 
security thus afforded. In other cases the adhe- 
sion is to the diaphragm, or to another portion 
of the alimentary canal, where, if perforation 
occur, the mischief is mitigated in comparison to 
what would otherwise be the result, because then 
the alimentary matters merely pass from one por- 
tion of the digestive tube to another. 

The last example we shall notice in this chapter 
is the cautious manner in which spontaneous eva- 
cuation of the contents of large abscesses takes 
place, and which the medical attendant, with all his 
skill, is never able fully to imitate. The opening of 
a large abscess is invariably attended with consid- 
erable risk. The immediate effect is generally 
to produce a large measure of relief to the patient, 
but in a short time irritative fever of a dangerous 
character succeeds. This is commonly attributed 
to the admission of air into the interior of the 
abscess, which acts as a foreign body, produces a 
change in the character of the purulent matter, and 
lights up a new kind of irritation on the walls. 
When the opening has been made by art, it is sel- 
dom possible to manipulate in such a way as to 
admit the escape of the contents, and yet prevent 
the admission of air ; but when nature undertakes 



160 PROCESSES 

the operation, she forms a long and tortuous chan- 
nel in the first instance under the integuments, 
through which she conducts the purulent matter, 
and finally erects a sort of sluice-gate near the 
surface, which allows of its flowing out easily, but 
imposes an effectual impediment against any thing 
which would attempt to force an entrance upwards 
in the opposite direction. 

Before leaving this subject it may not be amiss 
to notice an objection which seems capable of 
being raised, with some shadow of propriety, 
against the general scope of this essay, but more 
particularly against the views put forward in the 
present chapter. The objection is this: if the 
facts to which attention has been called be really 
instances of a direct interference with the obvious 
tendency of morbid action, is it consistent to 
maintain that God is at one and the same time 
the author of sickness and of those provisions 
which counteract its effects ? Would it be rational 
to suppose that an intelligent being, aware of 
what he was doing, would continue to destroy 
with one hand what he was attempting to effect 
with the other? And if such conduct would be 
absurd in the highest degree when attributed to 
an inferior creature, how much more so does it 
appear when the being to whom it is referred is 
the most perfect intelligence in existence? The 
whole force of this objection evidently lies in a 



OF PRESERVATION. 161 

misconception of the design intended to be effected 
by the appointment of sickness. If the destruc- 
tion of life were the sole or even the principal 
object to be accomplished, then there would evi- 
dently be an inconsistency in superadding to it 
any provisions of a salutary nature. But we have 
endeavoured to show that this is not the case, and 
that the suffering it induces and the loss of life 
are only subsidiary to a far higher and more 
important end. Viewed in this light, the institu- 
tion of a new series of provisions to check the 
rapidity of its progress, and to mitigate its violence, 
is but a link in the great chain of arrangements 
that have been planned for this object, and so far 
from establishing the charge of inconsistency that 
would be attempted to be fastened on its great 
Author, only tends to exhibit in a clearer way the 
depth of His wisdom and the perfection of His 
work. 



14* 



162 OF PROCESSES 

CHAPTER IX. 

OF PROCESSES OF REPARATION OCCURRING IN DISEASE. 

If the argument adduced in the last chapter be 
admitted on examination to possess any force, that 
which is now to be brought under the notice of 
the reader, will be found to be no less deserving 
of his attentive consideration. It consists in the 
fact, that when a morbid action is set up in any 
part, that action is not left to proceed to the de- 
struction of the structure or of the patient's life, 
without an attempt being made by the powers of 
the constitution to correct its tendency, and to 
restore the individual to the full enjoyment of his 
proper state of health. In other words, a process 
of reparation is set up by nature, quite indepen- 
dently of any artificial interference on the part of 
the patient or his physician. Now, this attempt 
at reparation, whether successful or not, carries 
in the very fact of its occurrence a conviction, 
that it is not the result of a blind chance working 
in the dark, but of an intelligent cause presiding 
over and directing its operations, because other- 
wise it is impossible to conceive that the change 
could take place at all. Matters might indeed 
get worse, but they could never improve. The 



OF REPARATION. 1G3 

continued operation of the morbid influence might 
easily aggravate the patient's condition, but it is 
absurd to suppose, that in the very midst of its 
progress it should suddenly be arrested, and 
that the vital forces should assume a new and 
healthy character, without either a special, though 
unseen, interference at the moment of the change, 
or a law of the constitution originally implanted 
for the purpose coming into play to produce the 
effect. In either case it is a proof of design in 
contriving the arrangement, and if so, of benevo- 
lence as well, because the only object for which 
such a design can have been formed, must be the 
benefit of the individual immediately concerned. 

This power, which is commonly designated by 
medical writers the "vis medicatrix naturce" is 
constantly exhibited in every form 6f disease, and 
its importance in the practical management of any 
case cannot possibly be over-estimated. Indeed, 
it maybe fairly asserted, that it is to this beneficial 
influence that the recovery of patients is mainly 
to be attributed: because, although injudicious 
treatment may counteract its efficient progress, 
or altogether prevent its successful issue, no 
amount of skill or attention, on the part of the 
medical attendant, can supply the want of energy 
in the constitution, when it happens to be defi- 
cient. The physician's care is merely to assist 
nature in her various struggles, by removing 



164 OF PROCESSES 

every obstruction to her effectual operation, and 
by imparting strength to the vital forces, when 
too weak to accomplish of themselves the purpose 
at which they aim. 

The first illustration I shall select shall be taken 
from the class of fevers : of these there are three 
distinct kinds — the periodic, the specific, and the 
continued. Each of these classes will exemplify 
the principle under consideration. Ague may be 
taken as the type of the first class. It consists, 
as every one knows, of a succession of paroxysms, 
varying in duration and in intensity, according to 
the particular species of the disorder. When the 
paroxysm has passed away, the patient enjoys, to 
all appearance, his ordinary health, till the period 
at which the subsequent seizure occurs ; and when, 
through the agency of medicine or other means, 
the seizure does not recur, he is cured. In this 
case, then, in the midst of a febrile paroxysm, 
whether produced, as is commonly supposed, by 
the action of a morbid poison, called malaria, or 
not, the vital forces, after struggling for some 
time with the insidious enemy, are enabled to 
resume their healthy action, and to perform their 
proper functions in their accustomed manner. 
We are not speaking now of the cure of the 
complaint, but of the termination of the paroxysm. 
The ague continues, though the paroxysm passes 
off. But when the change occurs from the 



OF REPARATION. 165 

obvious intensity of a burning fever, to the cool 
and tranquil condition of apparent health, what 
is it that determines its development? A 
change, be it observed, that takes place inde- 
pendently of medical treatment, antecedently to 
the administration of remedies, and from the very 
invasion of the complaint. Its occurrence is a neces- 
sary part of the natural history of the disease. How, 
then, is it possible for these forces, w r hen oppressed 
and trodden down, as it were by a load too heavy for 
them to sustain, to recover themselves in such a 
way, as to throw off the weight and assert their 
original energy ? Is it not due to a natural elas- 
ticity, implanted in the system with this very 
intention, and which, like an ordinary spring, 
increases its resistance in proportion to the strain 
it has to bear. 

The same thing is more plainly shown by the 
specific fevers. In this class are included measles, 
small-pox, scarletina, &c. They are marked by 
distinct and peculiar features, such as being highly 
infectious, running a definite course, and being 
rarely taken a second time by the same individual. 
Their dependence upon a subtle, but inappreciable 
morbid poison, is generally admitted from the cir- 
cumstance, that they are capable of being readily 
propagated by inoculation. Now, in each of these 
affections, we are able to discover within certain 
limits, a remarkable regularity in their progress. 



16G OF PROCESSES 

Most of them are attended with eruptions on the 
skin, which appear at definite intervals, and go 
through a succession of changes, till their final 
disappearance, leaving the patient weak, but well. 

What is it that determines the succession of 
these phenomena with such astonishing precision ? 
If they depend upon the contamination of the 
system by a specific poison, what is it that enables 
it at last, after a protracted struggle, to effect its 
elimination ? If the system is unable to resist its 
injurious influence at first, how is it enabled, 
after it has spread its noxious influence through 
every portion of the frame, ultimately to secure 
the victory ? Must there not be a power in the 
constitution sufficient to effect its expulsion, 
which begins its operation at some fitting period, 
after the development of the fever, and which 
concludes its task with unerring certainty at the 
proper time ? 

The same thing is true of continued fevers also. 
Ordinary typhus may be taken as the example of 
this class, which differs in several important par- 
ticulars from those we have just referred to. 
There is little doubt that they also depend upon 
a peculiar poison, but of a different kind. They 
do not appear to run a definite course, and their 
duration in different cases varies remarkably. 
Some cases terminate in a few days, and others 
run on to three weeks, and even longer. But they 



OF REPARATION. 167 

exhibit, in common with other fevers, a tendency 
to terminate abruptly. This circumstance, which 
is usually called a crisis, though questioned in 
modern times, in consequence of the prevalence 
of peculiar pathological views, was universally 
maintained by all the older physicians, who were 
emphatically men of observation, and is again 
generally admitted by the best informed and most 
experienced practitioners of the present day. 
Now, the remarkable feature concerning these 
crises is this, that although highly beneficial 
when they do occur, they owe their existence 
solely to the spontaneous efforts of the vital 
powers. The physician is unable, by the exercise 
of all his skill, to bring them about without the 
assistance of the constitution. He may, and per- 
haps often does, by injudicious interference, 
retard or prevent their occurrence ; or, on the 
other hand, he may by well-directed management 
facilitate their appearance, but they are not his 
doing. Were it possible for the powers of medi- 
cine to develope them, we should undoubtedly 
have them taking place with greater regularity, 
and at an earlier period, than they usually do in the 
progress of the malady. But how are we to ex- 
plain their production ? The natural functions 
have been all in abeyance during the previous 
course of the fever: the intellect perhaps sunk in 
stupor, or oppressed by delirium : what is to de- 



168 OF PROCESSES 

termine the sudden and successful termination of 
that, upon which all this train of morbid pheno- 
mena depends ? We can only refer it to a wise, 
but mysterious appointment in the economy of 
nature originally implanted for the merciful pur- 
pose of counteracting, to a certain extent, the 
destructive agency of those very diseases that 
the all-wise Author of our existence intended we 
should be liable to. 

Our next illustration shall be taken from the 
process of cicatrization. The very fact of such a 
process being observed in the body, is a proof 
of the correctness of the views here put forward; 
but an examination of the process in detail, will 
help to establish them more fully. Whenever 
there has been a loss of substance in any part of 
the body, from accident or disease, the vessels in 
the immediate vicinity of the spot, take on a new 
and peculiar action to fill up the deficiency. That 
this mode of action is a new one called into being 
by the exigencies of the occasion, will be evident 
from a little consideration of the ordinary process 
of nutrition. It is generally known, that during 
the whole period of animal existence, a slow and 
imperceptible, but steady change, is constantly 
going forward in all parts of the framework of 
our bodies, so that at no two periods of our lives 
does the material organization of which they are 
composed, consists of exactly the same particles of 



OF REPARATION. 169 

matter. The rapidity with which this change pro- 
ceeds, varies at different epochs, and in different 
structures, but it is never entirely suspended. It is 
accomplished by the combined and simultaneous 
action of the antagonistic functions of nutri- 
tion and absorption: the former selecting from 
the mass of food which is daily consumed, appro- 
priate elements for the repair of the various 
tissues, and depositing them in the situations 
where they are required: the latter, on the con- 
trary, removing those which have already served 
their purpose, and are no longer needed for the 
wants of the system. When the period of growth 
has been completed, these functions, if the indi- 
vidual is in health, exactly correspond. Nutri- 
tion supplies no more than is needed to repair the 
waste, and absorption takes away no more than 
the former is able to supply. When the balance 
is destroyed, corpulence or wasting is the neces- 
sary result, according as the energy of one or the 
other of these functions happens to preponderate. 
But even this, within certain limits, is quite com- 
patible with health. So long as the molecules of 
matter, furnished by the nutrient vessels, are 
analogous to those which properly exist in the 
living structures, and in the precise positions where 
they are found, the deposit, even though in a 
slight excess, may be referred to the ordinary 
operation of the function in question. But when 
15 



170 OF PROCESSES 

we find a new kind of matter thrown out in any 
part, we must refer its production to a new and 
unusual kind of action taking place at the time: 
and this is what actually occurs in cicatrization. 
The ordinary operation of nutrition and absorption 
would leave an ulcer in precisely the same condi- 
tion in which it finds it : or if there were a slight 
excess of deposition, there might be produced a 
swelling of fat or muscle at the spot, but it would 
be in vain for us to expect the regular formation 
of all the lost tissues in the exact proportion 
that would be requisite to repair the injury. But 
this is what actually takes place. A new and 
highly vascular structure of a spongy appearance, 
called " granulations," is produced, which gradu- 
ally fills up the hiatus with the precise kind of 
matter it originally held, until the entire space 
becomes occupied, when the upper surface con- 
tracts upon itself, so as to stretch the cuticle 
from the edges of the sound portion across the 
wound, until the entire is covered over. 

One of the most remarkable examples of the 
process of reparation occurs in the case of a frac- 
tured bone. When such an accident takes place, 
the assistance of a surgeon is immediately secured, 
and the limb put in a proper position for the bones 
to reunite : but, as has been already remarked, 
when the surgeon has performed this duty, his 
work is at an end : it is the silent and unseen, but 



OF REPARATION. 171 

effectual operation of the living organism that 
must do the rest ; and this is accomplished by an 
arrangement as beautiful as it is simple. A 
peculiar fluid is poured out in the immediate vici- 
nity of the broken pieces of bone, which coagulates 
and becomes organized ; it then assumes the con- 
sistence of gristle or cartilage, and finally it is 
converted into bone. In this process there is 
adopted a contrivance analogous to what surgeons 
are accustomed to employ for giving support to 
the ends of the fracture, only much more appro- 
priate. For while the surgeon adapts his clumsy 
splints to the sides of the limb, and fills up the 
vacant spaces* between the board and the integu- 
ment with wadding or cushions, nature makes 
use of a circular ring, which invests the bone on 
all sides, and accommodates itself to its exact 
shape and necessities. Nor is this all. There is 
another splint^ if it may be so called, inserted into 
the hollow cavity in the interior of the bone, so 
as to increase its strength and stability, until the 
newly-formed portions have acquired sufficient 
firmness to need these artificial helps no longer. 
This augmentation in the amount of bony matter 
at the point of fracture is analogous to the way 
in which two pieces of iron are welded together: 
the increase in the solid element, augmenting the 

* Modern surgery has imitated nature's operations more 
closely, by various contrivances, which are not liable to the 
same objections as the one stated in the text. 



172 OF PROCESSES 

strength of the part, and diminishing the chance of 
subsequent fracture. Both of these very important 
securities, the external ring of osseous matter, 
and the internal deposit, remain a considerable 
time after the fracture has been satisfactorily 
united, because whenever a tissue has been re- 
cently formed, it is deficient in consistence and 
tenacity, but as the necessity for their continuance 
diminishes, they are gradually absorbed until the 
bone is left in a condition similar to what it pos- 
sessed originally. In all this we see not only the 
broad feature of a new and beautiful contrivance 
to meet a special case, but when we examine it in 
detail, we find the same principle still more 
apparent. What is it makes the vessels pour out 
at such time a fluid with such peculiar properties, 
and not on other occasions ? What causes carti- 
lage to be formed in an unusual situation? What 
converts that cartilage with such unwonted 
rapidity into bone ? What causes the absorbents 
to leave the superfluous bony matter so long on 
the outside and inside of the new bone ? What 
causes them again at a subsequent period to 
remove it after its work has been accomplished, 
and when it is no longer necessary for any useful 
purpose? These are questions which it would 
be very hard for any one to answer, who believes 
that accidents and disease are the result of 
chance or the work of an evil spirit ; but they 
present no difficulty to him, who believes that 



OF REPARATION. 173 

they are the appointment of One who chastens 
us for our good, and who mixes up mercy with 
every manifestation of judgment. 

The next illustration we shall direct attention 
to is the power of selection that the absorbents 
appear to possess in the performance of their 
office, so that they do not take up, indiscriminately, 
the particles of matter diffused through the body, 
but those only which are least necessary for the 
purposes of the economy. We have already had 
some examples that illustrate this position, but 
we shall select another from what occurs in in- 
flammation of the eye. In this organ, owing to 
the transparent nature of the textures, we are 
enabled to watch the progress of the changes that 
take place there with great exactness. When the 
iris, that beautiful curtain that is suspended in the 
interior of this animated telescope, for the pur- 
pose of regulating the quantity of light that falls 
upon the nerve of vision, happens to be inflamed, 
its shape is altered by the contraction of the 
lymph deposited upon its surface, and its colour is 
changed. This effusion is caused by the morbid 
action of the nutrient vessels. Let us suppose 
that such a case has been judiciously treated in the 
ordinary way, and that the patient is recovering ; 
under such circumstances the lymph becomes 
absorbed, the iris resumes its original shape and 
colour, and recovers its power of adapting itself 
15* 



174 OF PROCESSES 

to the varying intensity of the light, to which the 
eye is exposed. Now, the remarkable circum- 
stance to which we are anxious to direct attention, 
is, that while the energy of the absorbents is 
enormously increased under the action of me- 
dicine, they do not remove, indiscriminately, the 
particles of which the iris itself is composed, but 
the lymph, which is entangled in the meshes of 
its texture. And yet, why do they not? What 
gives them this strange discernment, by which 
they are enabled to discriminate with unerring pre- 
cision, what is noxious from what is necessary ? It 
certainly is not the medicine, for that appears to 
act solely in increasing the general rate at which 
they move, and in augmenting their energy. The 
same thing happens in other cases also, when this 
organic sensibility is manifested, and where me- 
dicine can have nothing to do with the result. 

The only other illustration we shall bring 
forward under this division of the subject, is 
taken from the history of aneurism — a disease 
affecting the blood-vessels, and consisting of a 
tumor, connected with their course. The sides 
of the arterial tubes are formed of three distinct 
membranes or coats, of which the external alone 
possesses any considerable degree of extensibility. 
This quality enables it to resist injurious impres- 
sions more effectually than the others. It conse- 
quently happens, not unfrequently, that the two 



OF REPARATION. 175 

internal tunics arc ruptured, while the external 
retains its integrity. The blood escaping through 
the laceration forces the external membrane 
before it, and forms a swelling of greater or less 
dimensions on the side of the wounded vessel. 
It is scarcely necessary to observe, that such an 
event must be attended with the greatest danger. 
Were the whole three coats to give way at once, 
death would instantly follow, if the artery hap- 
pened to be a large one. It is the elasticity of the 
external coat that, in the first instance, is the 
principal protection against this fatal hemorrhage. 
After the disease has had time to develope itself, 
other safeguards are provided to assist, but at 
first the sole resistance to such a disasterous result 
is to be found in the strength and extensibility of 
the outer membrane. It may well be imagined, 
that if there be any reality in the doctrine we have 
been advancing, there should be easily discovered 
evidences of a preservative and reparative charac- 
ter in so formidable an affection, when the slightest 
shock to the system, mental or corporeal, is suffi- 
cient at any moment to hurry the unfortunate 
patient into eternity. Nor is this expectation, on 
investigation, found to be groundless. We dis- 
cover in the progress of the complaint, provisions 
to guard against sudden death, and provisions to 
promote recovery. The blood accumulated within 
the sac, and cut off in a manner from the rest of 
the circulation, gradually coagulates, and forms 



176 OF PROCESSES OF REPARATION. 

a succession of layers on the inside, which 
strengthen the walls of the vessel, and form a 
sort of breast-work against the threatened danger. 
Nor is nature satisfied with a simple effort to pal- 
liate so formidable an evil. An attempt at spon- 
taneous cure, though not often successful, perhaps 
from causes which are capable of explanation, is 
still very frequently made. The volume of the 
tumor gradually enlarging, and pressing upon the 
adjoining textures, is at last made to react upon 
the calibre of the parent vessel : the consequence 
is, that the current of the blood is interrupted, 
the opposite sides of the artery are forced together, 
inflammation is produced, and the vessel is con- 
verted into a solid fibrous cord. When this has 
happened, no further risk is to be apprehended, 
the pulsation in the tumor ceases, the absorbents 
begin to play upon it, and in a short time almost 
every trace of its previous existence disappears. 
It may be thought that such a result must be 
fraught with new dangers of another description. 
The obliteration of the artery, and the arrest of 
the flow of blood to any part of the body, cannot 
happen without corresponding injury. But careful 
nature leaves no part of her work undone : even 
these inconveniences are anticipated and guarded 
against. But the consideration of this point 
belongs to another division of the subject, which 
shall therefore be reserved for the next chapter. 



177 



CHAPTER X. 

OF PROCESSES OF ADAPTATION OCCURRING IN DISEASE. 

Many diseases, it is hardly necessary to remark, 
are found by experience to be incurable, though 
they exhibit no obvious tendency to prove imme- 
diately fatal ; the patients continuing to live and 
to discharge all the ordinary duties of society, not- 
withstanding their continuance. This result is 
occasioned at times by the neglect of proper 
treatment at an early period of the disorder, and 
on other occasions, by the peculiarly intractible 
nature of the malady. The inconvenience and 
pain that persons thus circumstanced are obliged 
to endure, are often very considerable, but their 
sufferings would, in most instances, be much 
greater were it not for certain alterations of 
structure, kindly introduced into the economy at 
such times, for the very purpose of meeting the 
altered condition of affairs, and of compensating, 
to some extent, for the disturbance in the animal 
mechanism that has thus unhappily taken place. 

These special arrangements to accomplish this 
object, may be called, not inaptly, processes of 
adaptation, and it shall be our business now to 
proceed to consider a few of them in detail. 



178 PROCESSES OF 

The first to which we shall direct attention, has 
reference to the heart, as the great moving power 
of the circulation. We have already had occasion 
to point out the peculiar circumstances under 
which this important organ has to perform its 
office. Placed near the centre of the body, it has 
to propel a current of blood upwards towards the 
head, in opposition to the force of gravity, as 
well as to sustain the pressure of a column of 
fluid, contained in the cerebral vessels. In per- 
forming this duty, the heart is materially assisted 
by three valves placed at the commencement of 
the great artery, which issues from its base, and 
which, acting like the sucker of a common pump, 
permit the free escape of fluid in one direction, 
but effectually restrain its passage backwards. 
In consequence of this contrivance, the muscular 
structure is enabled to enjoy a short but real in- 
terval of rest between each successive contraction. 
But these valves, perfect as they are in health, 
are liable to disease, and rarely does it happen 
after such an attack, that they continue capable 
of discharging their function. Their edges be- 
come contracted or uneven, or they adhere 
together, or to the sides of the vessel, so that 
they no longer close upon the orifice, and the 
mechanism of their construction becomes imper- 
fect. Regurgitation takes place, and the heart 
has to sustain thenceforward the continuous 
pressure of the superincumbent blood. Its natural 



ADAPTATION. 179 

rest is destroyed, and the leverage of the mus- 
cular fibres, as must be apparent to every one 
conversant with mechanics, is placed under a 
striking disadvantage. 

Is such a state of things, when it exists, suf- 
fered to continue without some effort being 
made to correct or to compensate for its occur- 
rence, and if not, what is the provision made to 
supply the difficulty? The simple answer to 
such a question is, such a state of things is 
not suffered to remain exactly as we have de- 
scribed them, but the muscular structure of the 
heart becomes hypertrophied — in other words, 
greatly enlarged, whereby its motive power be- 
comes increased in a degree somewhat propor- 
tioned to the augmented duty it has to perform. 
Were it not for this circumstance, it would be 
absolutely impossible for this organ, so essential 
to life, to continue to act for any time without 
rest and without assistance. And here it is not 
sufficient for us to remark, that nature has pro- 
vided a method to relieve so distressing a malady, 
it becomes us also to ask what is it that calls this 
hypertrophied condition into existence ? It cannot 
be the mere mechanical force of the column of 
blood pressing downwards on the heart, for if that 
were left to act of itself, the only effect it would 
be capable of producing would be, to enlarge the 
capacity of the heart by dilating its sides, as 
occasionally happens, and by expanding the mus- 



180 PROCESSES OF 

cular fibres to diminish their strength. Such a 
state of things would go on, deteriorating with 
rapidly increasing velocity, till the attenuated 
organ would be broken through, and the death of 
the patient effected. There must be then some 
special law in the economy to counteract this 
tendency, and to ordain that vigour and strength 
shall be supplied to those parts which peculiarly 
require them, otherwise it would be impos- 
sible to conceive that the growth of a tissue 
should bear a proportionate ratio to the exigencies 
of its position. And if such a law does actually 
exist, it can be the result of nothing less than of 
deliberate foresight and design. 

Let us proceed to consider another example 
connected with the circulation, but having refer- 
ence to the veins. This set of vessels differs 
from the arteries, not only in the quality of the 
blood they carry, but in the rate of the current, 
and in the forces that maintain it. In the arteries 
the blood moves rapidly in a jerking manner, giving 
rise to the phenomenon of the pulse. This arises 
from the cause of motion in these vessels being 
principally, if not exclusively, the contractile 
energy of the heart. In the veins, on the contrary, 
the current is remarkably slow and tranquil, and 
altogether destitute of those waves or pulses that 
are conspicuous in the arteries. The reason of this 
is, that the blood in passing through the minute 



ADAPTATION. 181 

vessels called capillaries, that lie between the 
extremities of the arteries and veins, is removed 
from the influence of the heart's action, and is 
brought under the operation of other forces that 
act more uniformly. But these are not the only 
differences between these two sets of vessels; 
they differ remarkably in structure also. The 
coats of the veins are thinner and weaker, and 
furnished with valves at suitable distances on their 
interior. These valves permit the blood to ad- 
vance freely in their proper course, while they 
restrain every movement in the opposite direction. 
But they serve another purpose also. By dividing 
the column of blood into several distinct portions 
they relieve the lower division of the vessel of 
a considerable part of the weight they would 
otherwise have to sustain, and so enable the thin 
delicate coats of which they consist, to resist the 
pressure of the fluids they contain. It is a well 
established principle in hydraulics, that the pres- 
sure upon any part of a tube is proportional, not 
to the absolute quantity of fluid it may happen to 
contain, but to the height of the column in which 
it is sustained above the part. Apply this prin- 
ciple to the veins, and we shall find that, near the 
heart, the veins, from their large size, contain a 
large quantity of blood, while the lateral pressure 
on their sides is small. In the extremities, on 
the contrary, though the diameter of the vessels 
16 



182 PROCESSES OF 

is trifling, the pressure on their sides is consider- 
able, because the vertical height of the liquid 
column is then great. The valves are few in 
number in the former situation, where they are 
little needed, but they are numerous in the latter, 
where their utility is obvious. By breaking the 
whole extent of the veins into several short and 
independent tubes, they relieve the parietes 
which would otherwise burst and discharge their 
contents into the surrounding tissues. Now, it 
not unfrequently happens, that the veins of the 
legs, which from their depending position have 
the greatest weight of blood to support, be- 
come swelled in their transverse diameter, so 
that the valves which, under ordinary cir- 
cumstances, are sufficient to cover the opening, 
become no longer capable of stretching across 
the whole way, and a portion of the blood 
makes its way back to the lower parts of the 
vessel. In proportion as this occurs their office 
fails, and hydrostatic pressure passes downwards 
through the whole length of the tube. This 
varicose condition, as it is called, is usually pro- 
duced by the compression of a tumor on the upper 
part of the vein, or by the habit of wearing tight 
garters, which interfere with the due advance of 
the particles of blood. Persons who are thus 
affected, are particularly liable to suffer from 
troublesome ulcers on the legs, which often bleed, 



ADAPTATION. 183 

and are productive of much annoyance. But the 
evils which are thus occasioned, and which are 
always extremely difficult of removal, are in a 
measure mitigated by the increased thickness of 
the venous coats that is observed to take place 
under the circumstances, so that the vessels are 
enabled to bear a degree of pressure that they 
would not otherwise be capable of doing. Here 
again we see the growth of a tissue preserving 
a proportion to the amount of duty it has to 
perform. 

In the last chapter we spoke of the provision 
that nature makes for the cure of aneurism. This 
desirable object is seldom effected by the unaided 
resources of the economy, though it is often cured 
by the skill of the surgeon. Indeed the treatment 
of these dangerous tumors, is one of the most 
brilliant pages in the history of modern science : 
so sure and so successful has the management of 
these cases become, which a few years ago would 
have been considered absolutely hopeless. But 
whether brought about by the unassisted efforts 
of nature, or by appropriate treatment, the result 
in all cases is the same, so far as the vessel itself 
is concerned. It becomes stopped up at the part, 
and is no longer capable of transmitting blood. 
This, when the artery is of any considerable size, 
would be attended with the greatest injury, were 
there not established at the same moment, a cor- 



184 PROCESSES OF 

responding provision to supply nourishment and 
vitality to the parts of the body thus unexpectedly 
deprived of their accustomed support. Gan- 
grene of the foot is not an uncommon result of 
such a condition, occurring in old persons, where 
the arteries of the leg have been attacked with 
inflammation, and sealed up in consequence. To 
guard against this danger, we find a suitable pro- 
vision made to meet the emergency. Immediately 
above the place where the aneurism was seated, 
one or more of the branches proceeding from the 
same arterial trunk become enlarged, so as to 
receive an equivalent quantity of blood, to what 
formerly passed in the direct channel. These 
branches taking a circuitous course, gradually 
establish a new circulation in the parts deprived of 
their usual elements of growth, so that the func- 
tions of life are soon performed with all their 
accustomed energy and efficiency. It may be said, 
perhaps, that this is the necessary consequence 
of the pressure of the arterial current, which is 
now forced upon the smaller branches in the 
vicinity of the obstruction, and not the result of 
any special contrivance to counteract an admitted 
inconvenience. But even were we to admit that 
the effect in question is produced in the manner 
stated, it would not in the slightest degree inter- 
fere with the inference, that it is the result of 
design. We see that a necessity exists for a col- 



ADAPTATION. 185 

lateral circulation ; we see that in due time that 
collateral circulation is provided: it is a mat- 
ter of comparatively little consequence what 
the precise modus operandi is that is em- 
ployed in providing it. But the objection itself 
falls to the ground when we remember that, 
owing to the peculiar structure of the arteries, 
the pressure occasioned by the obstruction to the 
circulation at one point is diffused uniformly over 
the entire vascular tree, and not concentrated, as 
might at first be supposed, upon the part imme- 
diately affected. The elastic nature of the tissues 
of which they are composed fully proves this. 
So that we are bound to explain the production of 
the collateral circulation, by an organic law of the 
economy, and not by the mere circumstance of a 
mechanical expansion. 

The next example we shall take from the mor- 
bid anatomy of the liver. One of the purposes 
accomplished by this gland is, to act as a reser- 
voir under certain circumstances for the blood. 
It will easily be understood that as the rate of the 
circulation varies at different times with the na- 
ture of the employment in which we happen to 
be engaged, congestion of the lungs would be fre- 
quently induced, were there not some provision 
made to relieve them of the load of blood at such 
times thrown upon them. The first effect of 
exercise taken suddenly must be to propel a 
16* 



186 PROCESSES OF 

larger quantity of blood forward by the veins 
towards the heart, than can be transmitted by it 
through the arteries. After a time these two pro- 
portions may adjust themselves to one another and 
to the altered condition of the function, but the 
first effect must evidently be to disturb the relation 
between them : and so far as it does this, to pro- 
duce inconvenience to the individual. This pul- 
monary congestion is not only attended with the 
risk of hemorrhage, itself a formidable evil, but it 
also interferes mechanically with the due aeration 
of the blood : because this latter function requires 
for its complete accomplishment an amount of ex- 
posure to the atmospheric air, proportioned to the 
quantity of fluid contained in the lungs. Now, the 
liver acts as a safety valve on these occasions, an 
office for which its spongy texture, and its situa- 
tion in the abdomen, where it can freely enlarge 
in volume, especially adapt it. Every one must 
have felt, at times, when he has begun to run 
quickly, a sudden sensation of fulness in the 
right side, accompanied by a sharp pain or stich 
there : this sensation is due to the rapid expansion 
of the cells of the liver with the blood it receives. 
Like the regulator of a steam engine, it adapts 
the supply of blood admitted to the lungs, to the 
exact amount they are capable of employing 
beneficially: the remainder is permitted to ac- 
cumulate within its vascular texture, till the 



ADAPTATION. 187 

strain upon the heart has been taken off. But it 
sometimes happens, more especially in persons of 
intemperate habits, that the liver becomes un- 
fitted for this office. Its volume is diminished, 
often to one-third of its natural size ; its vessels 
are contracted, and instead of being easily dis- 
tensible, it is firm and unyielding. What becomes 
of the lungs under this state of things ? Do they 
suffer the inconveniences that might naturally be 
expected from the change ? No ; they are protected 
by the simple arrangement of the spleen being 
called on to perform the function that the liver 
is no longer competent to discharge. The spleen 
is a reservoir as well as the liver, but of a much 
more limited kind: its duty being especially 
connected with the process of digestion, and to 
provide for the varying quantity of blood fur- 
nished to the stomach, in its states of activity and 
repose. Like the liver, when in health, its size 
is undergoing perpetual variation, being small 
when the accumulation of blood is trifling, and 
large under opposite circumstances. But when- 
ever the liver becomes permanently contracted, as 
in the disease called hob-nail liver, it is found to 
be permanently enlarged for the obvious purpose 
of meeting a necessity that does not usually exist, 
but which, unless obviated in this manner, would 
be productive of injurious consequences. 

The last example to which we shall allude, has 



188 PROCESSES OF 

reference to the size of the heart in consumption : 
a matter apparently of little moment in so serious 
a disease, and one not generally taken notice of. 
But though not of much pathological importance, 
compared with other points in the complaint, it 
is interesting as illustrating the principle of adap- 
tation in the general economy. This organ, after 
death, is constantly found much smaller in con- 
sumption than usual : a result which is partly the 
consequence of that process of emaciation, which 
forms so prominent a feature in the complaint. 
The fat, and a portion of the muscular fibre, are 
removed by absorption, so that whatever its real 
dimensions may happen to be, it presents the 
appearance of being small and shrunk. But 
emaciation is not the only cause of the alteration. 
There is a real as well as an apparent diminution. 
The change in question is the result of a reduc- 
tion in the quantity of the circulating fluids, 
whereby the vessels lose their tension, and the 
pressure upon the cardiac cavities is gradually re- 
duced ; just as we know that the volume of an 
elastic globe depends altogether upon the amount 
of fluid it contains. This reduction in the quan- 
tity of blood, in consumptive patients, is brought 
about by exhausting discharges, and especially 
by the profuse perspirations at nights, with 
which they are commonly affected. Now, in 
this circumstance, we have an illustration of the 



ADAPTATION. 189 

way in which the economy is altered to meet the 
effects of disease. The lungs, from the destruc- 
tive changes that take place in their structure, 
become no longer calculated to perform the 
function of respiration, or even to transmit the 
blood, except to a very limited degree : vascular 
accumulations, hemorrhage, and various kinds of 
distress would be the necessary consequence, were 
not the quantity of blood reduced to an amount 
proportioned to the altered capacity of the lungs. 
When this has taken place, painful as the pro- 
cess by which it is effected may be, and tem- 
porary as the relief usually is, yet the patient's 
condition is rendered much more safe, if not 
more comfortable than it would otherwise be, 
were the vessels to retain the quantity of blood 
that is usual in the standard of health. 

It is scarcely necessary to pursue this subject 
farther. Many other examples might be adduced, 
all tending to show that in chronic affections, 
especially those which have no obvious tendency 
to destroy life, there is a kind and admirably 
adjusted adaptation in the mechanism of the hu- 
man frame, to enable it to endure evils which 
cannot be shaken off, and to resist impressions 
which it is perpetually exposed to. 



190 DISEASE ILLUSTRATIVE 



CHAPTER XI. 

OF THE USE OF DISEASE, AS AFFORDING ILLUSTRATIONS 
OF SPIRITUAL TRUTH. 

Having so far considered the evidence of design 
furnished by the phenomena of disease, it may, 
perhaps, be thought unnecessary to pursue the 
examination of the subject farther: but we should 
be guilty of a flagrant omission, were we to avoid 
noticing another important purpose, that it ap- 
pears calculated to accomplish, but which may 
not be so obvious to an ordinary observer, and 
that is, its suitableness to illustrate the great 
doctrines contained in the sacred Scriptures. 
That it was designed to accomplish this purpose, 
in addition to the others which have been men- 
tioned, can scarcely be questioned by any one 
who admits the truth of Revelation. Every page 
of the inspired record abounds with expressions 
originally taken from the language of medicine, 
which are applied figuratively to express the 
condition of the soul, as it exists under the domi- 
nion of sin. This mode of inculcating truth by 
analogies and emblems, possesses many advan- 
tages over the simpler forms of didactic instruc- 



OF SPIRITUAL TI1UT1I. 11)1 

tion. A plain statement of a fact or of a truth, 
though it may startle the hearer at first by its 
novelty, and though it may gratify him, by the 
addition it makes to his store of information, is 
yet deficient in many of those elements, which are 
necessary to make a proper impression upon the 
mind. It makes its way direct to the understand- 
ing ; it requires no explanation to act the usher, 
and introduce it into the presence-chamber of 
reason ; it induces no exercise of thought ; it 
gives no scope to the imagination. The whole 
work necessary for its perception is accomplished 
in an instant, and the mere effort of attention is 
all that is requisite to enable it to produce its full 
effect. But the ease with which it is at first ap- 
prehended, only diminishes the impression that 
it produces subsequently. And this is still more 
strikingly the case, when the same idea happens 
to be a second time presented to the mind. The 
original want of ornament in the language is then 
peculiarly injurious, because the charm of novelty, 
which compensated in some measure for the de- 
ficiency at first, is under these circumstances 
necessarily lost. Figurative teaching, on the 
contrary, by throwing a thin obscurity over the 
subject of which it treats, obviously quickens the 
perceptive powers, to discover the latent mean- 
ing of the language that is employed, and by 
exciting the natural curiosity of the hearer, makes 



192 DISEASE ILLUSTRATIVE 

the impression it produces deeper and more per- 
manent than it would otherwise be. Besides, by 
calling into requisition the playful faculty of the 
imagination, it gives rise to the highest intellec- 
tual gratification of which the human mind is 
capable. And this not at the moment only when 
the idea is heard for the first time. Even on sub- 
sequent occasions, in consequence of the way in 
which the various faculties of the mind are called 
into exercise, it retains much of its original fresh- 
ness, and of its power of producing agreeable 
emotions, that it possessed at first. 

It can scarcely be matter of surprise then, that 
a system of teaching which possesses such mani- 
fest advantages, should be largely employed by 
the divine Being, in His arrangements for com- 
municating instruction to His creatures. We 
know that it has been thus used in the pages 
of Revelation. The types and ceremonies that 
abound in the Old Testament dispensation espe- 
cially, are all proofs in point of the truth of this 
assertion. And there is reason to believe, that, 
even in external nature, many of the physical 
phenomena that surround us are really emblema- 
tical, though the clue to the right interpretation 
of them has been obscured or lost. 

But to return to the immediate subject which 
we have proposed for our consideration in the 
present chapter, we shall commence with a few 



OF SPIRITUAL TRUTH. 193 

remarks on the leprosy of the ancients, both 
because of the striking peculiarities that it pre- 
sented, and still more because no question can be 
raised as to the fact of its having been originally 
designed for the very purpose to which we are 
now about to apply it. The first particular to be 
noticed is the remarkable law that excluded the 
leper, as an unclean person, from intercourse with 
the rest of the community. This, doubtless, 
arose from the contagious nature of the malady, 
and was framed for the purpose of preventing the 
propagation of the complaint among the healthy. 
The effect of the enactment was, to render the 
unhappy man's condition most miserable. As if 
the sufferings of the disorder were not sufficient 
to distress him, he was made an outcast from 
society, and even his nearest relatives and most 
familiar friends were cut off from any intercourse 
with him. Nor was this all. He was debarred 
from all participation in the privileges of religious 
worship. He dare not enter the sacred precincts 
of the sanctuary, even to bend his knee in prayer, 
or to lift up his voice in praise. What rendered 
the force of these evils the greater was, the 
uncertainty of the length of time they might 
continue. Unlike those which have been termed 
acute disorders, from the shortness of their dura- 
tion, the leprosy lasted an indefinite period, 
and, to the large majority of patients, the grave 
17 



194 DISEASE ILLUSTRATIVE 

alone afforded the hope of release. In all this 
we may notice a marked distinction from other 
ailments. Many of them, no doubt, were as infec- 
tious as the leprosy, yet the patients who were 
attacked by them were not driven to the soli- 
tary outskirts of the camp or city, as the lepers 
were. Other complaints produced on the minds 
of the by-standers sympathy, and a desire to 
render them every assistance in their power ; this, 
on the contrary, only aversion and disgust. Have 
we not in all this a striking illustration of the 
nature and effects of sin? It contaminates every 
person with whom it comes in contact. "Evil 
communications/ ' it is written, "corrupt good 
manners.' ' It excludes effectually from the celes- 
tial city, and from the society of Heaven. It 
excites not so much pity on the part of the un- 
fallen angels, as horror and disgust. It supplies 
no sustaining hope to the unhappy victim that the 
violence of the indwelling corruption shall speedily 
be removed, but it rather suggests the despond- 
ing thought, that it will only wear itself out in 
the final death of the soul. Who can contemplate 
the doom of the sinner, as he is to be cast out 
into outer darkness, apart from the companion- 
ship of the redeemed and of every thing that is 
good, without being struck with horror at the 
thought of such a state. Yet such we have reason 
to be assured, from the authority of the written 



OF SPIRITUAL TRUTH. 195 

word, is to be the melancholy lot of all the unre- 
generate. 

Again, the plague of leprosy affected not only 
persons but things, and so obstinately did the 
poison cling to whatever it had once infected, 
that it could only be removed by the complete 
destruction of the article. Houses had to be taken 
down, clothes and furniture to be burnt, before 
this object could be accomplished. And is not 
this also the case with sin ? These bodies of ours 
in which we live, like the plague-polluted habita- 
tion of the leper, are so saturated with the cor- 
ruptness of a fallen nature, that they require to 
be taken down in death, before the contamination 
can be got rid of. The world itself, with all the 
furniture of external nature that has been wit- 
ness to the wickedness of man, and an unwilling 
instrument in his hand for the accomplishment 
of evil, must yet be purified by fire, before it shall 
be fit for the residence of the redeemed. But if 
these tabernacles be taken down, it is only for 
the purpose of being built up again of new and 
more glorious materials, perfectly free from all 
their present imperfections, and altogether in- 
capable of future evil. And if the material world 
is to be burnt up at last, as prophecy distinctly 
teaches, it is only to make way for a new earth 
and a new heavens, wherein righteousness is to 
dwell eternally. 

A third feature in the leprosy was its progres- 



196 DISEASE ILLUSTRATIVE 

sive character. It never remained stationary. It 
was a constitutional distemper: and hence, al- 
though the external evidence of its existence was 
but a small spot in the forehead, it was as danger- 
ous in its nature, and as certain in due time to 
spread, as if it were more conspicuous and more 
extensive. And does not this correspond with 
what we know is the nature of sin. It is a con- 
stitutional malady of the soul: some forms may 
appear slighter and less deeply seated than others. 
Some may be more offensive in their outward as- 
pect than others, but the principle upon which 
they all depend is essentially the same, and un- 
less restrained or removed by the grace of God, 
they are all equally liable to spread and to 
increase in virulence, till the least offensive assume 
the grosser aspects of depravity. 

Lastly, the poor leper was altogether incapable 
of being cured by human means. The resources 
of art had no remedy sufficiently potent to meet 
the necessities of his case. On the first discovery 
of his condition he was directed to present him- 
self before the priest, but it was not with the 
hope that any thing was to be done for his relief, 
it was only for the purpose of having his exact 
state authoritatively determined. Even the minis- 
ter of the sanctuary was powerless before so in- 
veterate a malady. Not that it was always incur- 
able. A few rare cases occasionally got well, but 
it was not through the employment of any special 



OF SPIRITUAL TRUTH. 197 

means of cure. If cured at all, it was solely by 
the direct but secret interposition of the divine 
mercy. And whenever that happy change oc- 
curred ; whenever some outward symptoms of 
that real but invisible alteration had appeared, 
he was directed again to go before the priest, in 
order to have an authoritative announcement that 
his recovery was real, and not delusive. Such an 
assurance coming from such a quarter would be 
not only a guarantee to his friends that they 
might unreservedly communicate with him, but 
it would diffuse an abiding satisfaction through his 
own breast, in the feeling that he was not mis- 
taken as to the reality of his recovery. Can we 
not trace a similar train of events in the history 
of the sinner ? Is there any human power that 
can deliver him from the bondage of indwell- 
ing corruption? He cannot emancipate himself, 
neither can any friend or minister of religion. 
Under the searching ministry of the word, he may 
have the misery of his condition more clearly 
brought home to his conscience, but it is only the 
omnipotent energy of the Holy Spirit working 
inwardly upon his soul, and removing the leaven 
of evil, that is continually fermenting within him, 
that can effect the great change necessary to sal- 
vation. But when this change has been effected, 
and he has gone in spirit into the presence of the 
great High Priest of the upper sanctuary, and has 
17* 



198 DISEASE ILLUSTRATIVE 

received at His hands, the assurance of accept- 
ance and peace, how great is the joy that takes 
possession of his soul. With what confidence can 
he then betake himself to the assembly of the 
saints, and mingle in their communion. The 
exultation of the poor leper as, returning from the 
presence of the priest, he cast aside his clothes 
and returned to his family and his home, was 
nothing in comparison with the ecstatic delight 
with which the assured believer rejoices in his 
restoration to the favour and family of God. 

The next subject to which we shall direct the 
reader's attention, as affording another illustration 
of the same kind, is insanity. We shall not at- 
tempt to describe all the forms of this protean 
malady, but select one or two of those which are 
generally known, and which appear suited to the 
purpose. For instance, a man in the full enjoy- 
ment of bodily health, and possessing all the 
Eaental faculties necessary for the proper discharge 
of the duties of life, behaves himself in a way 
that convinces ,ev v ery .one who sees him, that he is 
not in his right senses,. He neglects his busi- 
ness ; he ceases to labour fpr the support of his 
family ; he squanders his property, Such a course 
of .conduct may be the result qf .a delusion, per- 
verting his judgment, or it s may occur indepen- 
dently of delusion. It may be impossible to 
account for it upon any rational principle. In 



OF SPIRITUAL TRUTH. 199 

either case the conclusion is equally clear. It is 
a matter of very little consequence, so far as his 
state is concerned, whether the time that ought 
to be spent in useful employment is wasted in 
idleness, in absurd pursuits, or in absolute mis- 
chief. It would be easy to produce examples of 
each of these forms of folly among lunatics, but 
the malady is the same, notwithstanding these 
slighter distinctions. One of the most striking 
features of the distemper is, the utter impossi- 
bility of convincing them that their conduct is 
inconsistent with sound reason. Arguments are 
of no avail when directed against such a state of 
mind. Even when they admit that their conduct, 
under ordinary circumstances, would be extremely 
foolish, they maintain that there are peculiarities 
in their case which altogether alter its character, 
and render it perfectly rational and becoming. 
Nay, they think that to act otherwise than they 
do would be to be guilty of the very madness 
with which they are charged. They all agree in 
entertaining a fixed conviction of the propriety of 
their own actions, and of the whole world, so far 
as it differs from them in opinion on this subject, 
being wrong. Have we not in these particulars 
an apt illustration of the conduct of worldly men 
in general ? Some spend their lives in frivolous 
amusement, and are emphatically men of plea- 
sure. Some are engaged in the grosser forms of 



200 DISEASE ILLUSTRATIVE 

vice, to their own infamy, and to the serious 
injury of every one who comes in contact with 
them. Some honestly pursue their proper calling, 
but in such a way as to forget that they have any 
thing else to attend to. Is it not madness to 
concentrate one's whole attention upon the brief 
engagements of the present life, to the complete 
exclusion of the momentous concerns of an eter- 
nal existence ? In what respect does the passion 
for accumulating a large balance at a banker's 
to lie there useless, differ from the passion of a 
drivelling idiot to heap up a quantity of sand, or 
shells, or broken delf ? Every one who is guilty 
of such gross neglect of his eternal interests, for- 
gets the great end for which he was called into 
being. He fails to make provision for a future 
day. He squanders his time — which is his pro- 
perty — in a reckless and unprofitable extravagance. 
And the impossibility of convincing him of the 
folly of his conduct, is no proof of his rationality, 
but the very reverse. It supplies the necessary 
link to complete the analogy between him and the 
poor lunatic, whose infatuation he is so ready to 
denounce. 

We have a still stronger instance in the case of 
monomania. In this form of insanity an indi- 
vidual labours under a delusion upon one solitary 
topic, while in every other respect his intellect 
retains its accustomed clearness. Such persons 



OF SPIRITUAL TRUTH. 201 

often possess a highly-cultivated mind, and are 
capable of reasoning with great closeness and 
ability upon every subject unconnected with their 
delusion ; so much so, that it is often difficult to 
persuade casual observers that there is any thing 
the matter with them. They manage their affairs 
judiciously. They make bargains and converse 
freely. But whenever the subject of their delu- 
sion is touched upon, in ever so slight a manner, 
their malady becomes apparent. And although 
it does occasionally happen that an infirmity of 
this kind may be closely concealed from general 
observation for a very long period, yet the more 
common occurrence is, that the delusion, whatever 
be its nature, is so twined round the thoughts and 
the affections of life as to influence, to a very 
great and to a very obvious extent, all the actions 
of the individual. So close is the connexion 
subsisting between our views upon various sub- 
jects, and so easily does a false impression impart 
its peculiar tinge to the whole of our intellectual 
existence. Now, in this we can easily discover 
an analogy to the way in which many shrewd 
men of the world are affected. They take up, 
without thought and without examination, cer- 
tain crude and false notions of the divine character 
and government, which have no more solid foun- 
dation than the empty conceits of a poor mad- 
man's brain ; and they are so impressed with their 



202 DISEASE ILLUSTRATIVE 

accuracy, that the whole of their conduct is as 
much influenced by them as if they were estab- 
lished and admitted truths. No mistake can be 
more important to a responsible creature than 
that which concerns the nature and attributes of 
the great Being with whom he has to do. Yet 
how few are willing to receive implicitly the state- 
ments of the only standard authority upon these 
very questions. Multitudes never set themselves 
seriously to inquire into the matter at all. Mul- 
titudes who do, form their opinions from vague 
impressions floating in their mind, and should the 
accuracy of their conjectures happen to be ques- 
tioned, disregard the evidence of an opposite 
nature that may be presented to them, but persist 
in clinging to their foregone conclusions, notwith- 
standing the explicit statements of the word of 
God. Is conduct such as this one whit more 
rational than that of the lunatic, who maintains 
the reality of his own delusion, in opposition to the 
evidence of his own senses, and to the testimony 
of competent witnesses ? 

But monomania exhibits itself in another form. 
It consists in a perversion of the feelings, when 
there is no delusion to sustain it. An individual 
entertains an unaccountable and an insuperable 
aversion to certain persons and places. This 
estrangement is principally manifested towards a 
man's immediate relatives or friends. It is seldom 



OF SPIRITUAL TRUTH. 203 

that strangers are ever regarded in this way. 
Every thing connected with the object of dislike 
participates in the feeling. The place of his 
dwelling, the books he reads, the people he 
associates with, all come in for a share of this per- 
verted affection. Does not this exemplify, in a 
striking way, the alienation of the natural mind 
from every thing that is good ? The carnal mind, 
we are told, " is enmity against God," and it re- 
quires very little experience of ourselves, and 
very little observation of others, to confirm the 
truth of the Scripture statement. Nor is this 
aversion based upon a delusion. It is a kind of 
moral insanity. It is a real but unaccountable 
hostility, and it is as permanent as it is deep. 
The objects of our dislike are really worthy of 
our best affections, and are, properly speaking, 
our kindest friends. But though we know this 
to be the case, we feel within our breast an un- 
conquerable repugnance to their society, and to 
every thing connected with them. 

We shall next speak of blindness, as affording 
a type of man's spiritual state by nature, and in 
doing so, no doubt can be entertained of the 
propriety of the analogy, because it has been used 
for this purpose by our blessed Lord himself. — 
John ix. 39. It is important to observe, that 
this state may depend upon a variety of causes. 
The nerve of vision may be paralyzed, constituting 



204 DISEASE ILLUSTRATIVE 

the condition that has got the name of amau- 
rosis. In this case there may be no impediment 
to the entrance of the rays of light into the eye, 
and yet the person may be incapable of seeing. 
In the clearest sunshine he is as much in the dark 
as in the thickest midnight. The impression is 
made upon the retina, but the insensibility of the 
membrane prevents its being conveyed to the 
mind. On the other hand, blindness may result 
from impediments of a mechanical nature inter- 
fering with the apparatus of vision, while the 
optic nerve retains its integrity. The eye is an 
optical instrument of the most delicate construc- 
tion, admirably adapted to convey the images of 
external objects to the proper place for their per- 
ception. But to be of any use, the glasses, so to 
speak, must be perfectly clear: if their transpar- 
ency be destroyed by any cause, it ceases to 
answer the purpose for which it was intended. 
This actually occurs, as most persons are aware, 
in the case of cataract, where the lens is con- 
verted into an opaque mass, and also in the case of 
inflammation, destroying the proper texture of 
the other tissues of the eye. Blindness produced 
by mechanical causes such as these, is seldom so 
perfect as that which depends upon amaurosis, 
because, should the rays of light penetrate in ever 
so slight a degree through these obstacles, into 
the chamber of vision, the soundness of the optic 



OF SPIRITUAL TRUTH. 205 

nerve enables it to take cognizance of their pre- 
sence, although their limited number may not be 
sufficient to enable it to see distinctly. These 
points, in the natural history of blindness, having 
been noticed, it may be remarked that similar 
distinctions may be observed in that spiritual 
state of which they are the emblem. Amaurotic 
blindness may be taken as a type of man's natural 
ignorance of spiritual things. He is not only 
in a state of darkness, but it is a darkness depend- 
ing upon a want of power in his perceptions : he 
is incapable of apprehending the truth, even when 
it is presented to his notice. Though placed in 
the most favoured circumstances in a Christian 
land, under a faithful ministry, with the clear 
light of evangelical truth shining continually 
around him, he is, until the grace of God quickens 
his spiritual perception, as dark in his knowledge 
of divine things as if he were living in the mid- 
night gloom of heathen superstition. The other 
forms of blindness appear properly to illustrate 
the ignorance of persons whose minds seem to 
have been partially enlightened, but who from 
prejudice, self-interest, worldly influence, or 
defective education, labour under false views of 
scriptural truth, notwithstanding the change that 
appears to have taken place in their real condi- 
tion. In such cases the light of revelation, 
struggling through the impediment thus inter- 
18 



206 DISEASE ILLUSTRATIVE 

posed between it and the conscience of the 
individual, produces some effect upon the life and 
character, though it fails to enable him to see 
distinctly and to walk consistently. 

Paralysis is another affection which may afford 
several apt illustrations of what we are continually 
observing in the world around us. It may exist 
in different degrees, and it may affect the nerves 
of sensation or of motion separately. When the 
paralysis is complete the nervous energy of the 
part is entirely destroyed, when it is incomplete 
it is only impaired. Each of these varieties may 
be distinguished in the two kinds of the affection. 
When the paralysis affects the nerves of motion 
and is complete, the limb hangs powerless from 
the patient, who is incapable of lifting it, as he 
would do in health, by the spontaneous exercise 
of volition. If moved at all, it can only be by the 
assistance of the patient's sound limbs, or by 
some one else. When the paralysis is imperfect, 
a certain degree of power remains in the part, 
but the movements are stiff, unsteady, and irre- 
gular. Occasionally convulsive twitches of an 
involuntary character come on in the limb, which 
are very distressing to the patient. These he can 
neither stop nor control. Similar varieties may 
be observed in that form of the complaint which 
affects sensation. In the highest degree the 
patient loses all feeling in the part. It may be 



OF SPIRITUAL TRUTH. 207 

touched, pinched, or even cauterized without his 
experiencing the slightest sensation, and if the 
experiment be performed on a part of the body 
removed from observation, he may remain in per- 
fect ignorance of what has been done to him at 
such a time. In a less intense form the sensibi- 
lity is merely impaired : the individual feels exter- 
nal impressions, but not as quickly or as acutely 
as he is accustomed to do. Sometimes, instead 
of being impaired, the sensibility is altered in a 
remarkable way ; the patient has an unusual feel- 
ing of chilliness, or of heat, or of pricking in the 
part, instead of the natural sensation he is accus- 
tomed to. All these varieties may be taken to 
represent more or less distinctly various states of 
human character. In the utter incapacity of 
doing any kind of good, and in the complete 
insensibility of the natural mind, we have a per- 
fect antitype of the more developed forms of 
paralysis. In the failings of really good men, we 
have an illustration of the minor degrees of the 
same state. Thus we find one man, owing to 
some peculiar infirmity, continually halting in his 
Christian walk, and exposing himself and the pro- 
fession that he makes, to unpleasant observation 
and to severe remarks. Another, whose step is 
more steady than the last, preserves a constrained 
attitude and an awkward appearance. A third, 
from whom we expect a ready response to every 



208 DISEASE ILLUSTRATIVE 

appeal made in behalf of what is good, seems not 
to feel the importance of the claim, and meets us 
coldly and hesitatingly. A fourth appears to have 
had his natural sensibility somewhat perverted : 
impressions that ought to excite in his mind joy, 
and gratitude, and humility, give rise unexpect- 
edly to resentment, dislike and aversion. 

There are several other points connected with 
disease which it would be both- interesting and 
instructive to consider in the present light, were 
it judicious to extend the present chapter to a 
greater length, but there is one point in particu- 
lar to which w T e are anxious to direct attention 
before closing, and that is, those latent diseases 
which have been so often alluded to. A man who 
is labouring under any ordinary complaint is 
affected in a way that renders the existence of 
that complaint obvious, not only to himself but to 
others also. But we have seen in the cases to 
which we refer, that it is possible for a man to 
be seriously ill and yet not be aware of his con- 
dition. Even his most intimate friends may have 
no conception of his real state. Thus, a man may 
have a large aneurism concealed in his chest or 
abdomen, without its producing the slightest 
symptom to render him conscious of the danger 
in w T hich he is placed. Such a man, though ap- 
parently in perfect health, is really walking on 
the threshold of the grave: the least exertion, 



OF SPIRITUAL TRUTH. 209 

the slightest injury, under such circumstances, 
would be instantly fatal. Now this appears to 
be precisely the condition of many professing 
Christians. They are sick, but they are not aware 
of it. The propriety of their external demeanour 
deceives the observers into a mistaken estimate of 
their real character : and lulls their own conscience 
to sleep, with the idea of sound spiritual health. 
There may be strict moral integrity, high and 
honourable feeling, great amiability of disposition, 
and singular exactness in the performance of re- 
ligious duties, while there is much that is wrong 
in the person's spiritual state; a deep and deadly 
disease may be gnawing at his vitals, notwith- 
standing these symptoms of robust health. The 
florid cheek, and the sparkling eye, and the con- 
sciousness of activity, are often associated with a 
state of the system very far from what is safe : 
and just in the same way, a man may have much 
peace of mind, be thoroughly satisfied with him- 
self, and be conscious of no particular crime, who 
is at the same time labouring under a deep and 
fatal delusion as to his real state in the sight of 
God. 



18" 



210 THE CONDUCT OF 

CHAPTER XII. 

OF THE CONDUCT OF THE PHYSICIAN AS ILLUSTRATING, 
IN SOME MEASURE, THE DEALINGS OF GOD WITH HIS 
CREATURES. 

The providential dealings of God towards his 
rational creatures, when considered in their 
individual application to particular persons, are 
often extremely perplexing. One man is seen to 
be deeply tried in the furnace of affliction, 
while another is permitted to enjoy uninterrupted 
health and prosperity: and yet, on examining 
their character and conduct, so far as human 
observation can extend, it is impossible to dis- 
cover a satisfactory reason for the difference in 
their lot. The mystery that obscures this sub- 
ject has not been suffered to envelop it without 
reason. It is evidently calculated to teach man 
submission to the divine sovereignty, and to exer- 
cise his faith in the wisdom and goodness of the 
divine appointments. Were we in all cases to see 
distinctly the reasons that actuate the divine 
Being in reference to these dispensations, there 
would not be any scope for the exercise of these 
Christian virtues. We should in that case submit 
to His appointments because they commend 
themselves to our approval, not because we felt 



THE PHYSICIAN. 211 

and acknowledge His right over us as our Crea- 
tor. Such a state would evidently be incompatible 
with the very essence of authority. To guard 
against the occurrence of these evils, God has 
very properly taken care to secure that our sub- 
mission to His will shall be unconditional and 
complete. But the very obscurity which He has 
thus in a manner been compelled to use to effect 
this result, is attended with a corresponding dis- 
advantage. It leads men who are not rightly 
informed as to the divine character, to question the 
propriety of His proceedings, and to draw wrong 
inferences as to His motives and government. 
For this reason it appears to be a matter of some 
importance to bring forward every thing calcu- 
lated to correct these false impressions, and to 
clear up the difficulties that a superficial exami- 
nation of God's providential dealings may possibly 
produce. A conviction of the importance of this 
object has led us to think that it would be desir- 
able to direct attention for a few moments to the 
conduct of the physician, in his intercourse with 
his patients, as calculated in some measure to 
illustrate and explain the principles upon which 
God is pleased to act in His dealings towards men. 
"When a medical man is called in to visit a 
patient, his first care is, to make himself as 
thoroughly acquainted with the nature of the dis- 
ease, under which the patient happens to be 



212 THE CONDUCT OF 

labouring, as he possibly can: and for this pur- 
pose he institutes a most searching examination 
into all the symptoms that are complained of: 
and asks for such information, connected with the 
origin and history of the disorder, as he thinks to 
be necessary. When he has succeeded in solving 
this problem to his own satisfaction, he proceeds 
to direct the treatment that his judgment and 
experience point out to be suitable to the malady 
that he has to deal with. He does not, generally 
at least, begin by telling the patient or his friends 
what is the particular ailment that he thinks the 
patient is afflicted with ; neither does he explain 
to them what is the necessity for the particular 
remedies he has thought proper to prescribe, nor 
the manner in which they may be expected to 
produce their effect. That would be to take the 
patient into consultation, and to divide with him 
the responsibility that properly attaches to his 
office. Such a course, though occasionally fol- 
lowed, is seldom in practice found to answer. 
Most persons, notwithstanding their natural curio- 
sity to learn the nature of their ailment, and the 
kind of remedies that are ordered for their relief, 
are too ignorant of the structure of the human 
frame, and of the laws of vital action, to be ca- 
pable of receiving information of a satisfactory 
kind upon these points. Even when the patient 
happens to be himself a physician, though the 



THE PIIYSICIAN. 218 

foregoing remark does not apply to him, yet 
experience proves that it is desirable to conceal, 
as much as possible, the views that the medical 
attendant has formed of his case. The very fact 
of communicating a full and candid statement 
upon these points is attended with this disadvan- 
tage, that it sets the patient to inquire in his own 
mind whether the physician may not possibly be 
mistaken ? Whether he has not overlooked some 
symptoms w 7 hich, if duly considered, would have 
led him to a different conclusion? And other mat- 
ters of a similar kind w T hich, by unsettling his 
mind, must have an obvious tendency to shake 
his confidence in the accuracy of his opinion, and 
so to render his compliance with the course of 
treatment directed hesitating and unsatisfactory. 
Seldom, indeed, is it that any person, however 
well informed he may be, or however strong his 
judgment, is capable of forming a correct opinion 
in his own case. His feelings, his apprehensions, 
his fancies creep in unconsciously to disturb his 
judgment, and to interfere with the operation of 
the remedies which are used for his relief. A 
knowledge of this circumstance will account for 
many things that are habitually practised in the 
art of therapeutics, but the precise utility of 
w T hich is, perhaps, not duly appreciated. For 
example, the writing of prescriptions in a dead 
instead of a living language ; the use of curious and 



214 THE CONDUCT OF 

technical symbols, which possess an air of mystery, 
in place of the figures and terms in ordinary use, 
to express the quantities of drugs that are di- 
rected in the prescriptions; the invention of 
new and scientific names for common diseases, 
instead of the older and more familiar appellations, 
are all only so may efforts to conceal matters 
which it is not thought desirable for the patient 
to be acquainted with. The great success of 
empirical pretenders to medical skill, a success 
too notorious to be questioned, depends princi- 
pally upon the care which they take to conceal 
effectually from every one, but especially from 
the party immediately concerned, the nature and 
composition of the remedies they employ. Now, 
if it be a matter of importance, in the treat- 
ment of ordinary disease, to conceal from the 
patient the course that is necessary to be pur- 
sued for his recovery, and that it is so, is esta- 
blished beyond the possibility of doubt, can it 
be a matter of surprise, that the great Physician, 
in dealing with a more delicate and dangerous state 
of things, should find it necessary to adopt a simi- 
lar reserve, in reference to the remedies he chooses 
to employ, and to the necessity for their adoption ? 
And if the experience of every-day life shows us 
that we can be induced, unreservedly, to place 
confidence in a fellow creature, who is frail and 
fallible like ourselves, so as to follow his prescrip- 



THE PHYSICIAN. 215 

tions, even when thus leading us in the dark, how 
much more readily ought we to entrust the whole 
management of our concerns to Him, who alone 
is competent to form a correct opinion of our con- 
dition, and who is at the same time 

"Too wise to err, too good to be unkind." 

Still further : a physician, when consulted about 
a case, particularly if it be one of any danger, does 
not hesitate to prescribe any remedies he may think 
necessary for his patient's benefit, though they may 
happen to be bitter to the taste or severe in their 
operation. What would be thought of a medical 
man neglecting to order a valuable medicine that 
he knew was exactly suited to his patient's dis- 
order, because he was unwilling to expose himself 
to the charge of unkindness, from its disagreeable 
smell or taste ? Would we look upon such a 
man as a person of sound judgment or of real 
benevolence? Would we not rather conclude 
that he was of a weak mind, ignorant of the prin- 
ciples of true humanity, and destitute of every 
feeling that was really great and good ? Ought 
he not, impressed with the responsibility of his 
position, to lay aside every personal consideration, 
and even to risk the forfeiture of his patient's 
friendship, were such a condition necessary to the 
performance of his duty, to secure, as far as lies in 
his power, the object he has in view, under the 



216 THE CONDUCT OF 

confident expectation, that though his conduct 
may be impugned for a time, and his motives mis- 
taken or assailed, yet in the end an unbiassed 
verdict of approbation would be pronounced in his 
favour ? Now, if this be true in reference to the 
unpalatable drugs, and painful treatment of an 
ordinary physician, with how much greater force 
does the reasoning apply to the dealings of God? 
True, his dispensations are often sufficiently severe, 
but then we may be satisfied that He sees them 
to be necessary ; and that no other plan of treat- 
ment would be exactly suited to the circumstances 
of the case. He tells us himself, "that He doth 
not willingly afflict nor grieve the children of 
men." — Lam. iii. 33. His wisdom, doubtless, when 
he sends the rod, perceives that such a course* is 
absolutely required, and in that case it would be 
inconsistent with His goodness to withhold it. 

Let us look a little further and consider a skil- 
ful surgeon when engaged in some capital opera- 
tion. With what a firm hold does he grasp the 
amputating knife, and with what steadiness of 
purpose does he commence the harrowing work. 
With unrelenting boldness he cuts through muscles, 
and nerves, and vessels, unmoved by the cries of 
his unhappy victim, and unaffected by the thought 
of all the pain that he is thus at each moment 
inflicting. He hears nothing, he sees nothing 
but the one great object; and with cold calculating 



THE PHYSICIAN. 217 

precision he pursues the operation, step by step, 
till the whole is complete : one would think, 
were we to judge by the stolid indifference of his 
conduct as thus exhibited, that he had no feeling, 
yet, under all this seeming unconcern, there may 
lurk as kind a heart as ever beat, and as keen 
a sentiment of sympathy as it is possible to con- 
ceive : but the exhibition of these feelings would 
be altogether misplaced at such a season : it 
would only defeat the great object he has in view, 
by rendering him incapable* of executing success- 
fully that important and arduous, but disagreeable 
work that is so essential to the future comfort 
and welfare of his patient. In the practice of this 
noble profession it is absolutely necessary for the 
surgeon to subdue his own feelings, if he would 
really alleviate those of others, and though for the 
time his character may be mistaken, and he may 
be calumniated as a cruel unfeeling man, yet the 
consciousness of the nature of the work in which 
he is engaged, and the conviction that he will ulti- 
mately be the means of conferring substantial 
benefit on a fellow-creature, may well sustain his 
spirit under such a trial, should it come, until at 
last he is enabled to reap the rich reward of his 
exertions, in seeing his patient's life prolonged, 
his pain alleviated, or his health restored. 

Now, if this be so in the case of a mere sur- 
geon — and that it is so, almost invariably, will 
19 



218 THE CONDUCT OF 

scarcely be questioned — is any man justified in 
supposing that God is less tender, or less kind in 
his dealings with his creatures, than a mere man 
is found to be ? True, he may for a long time 
disregard their most pitiful cries — he may keep 
them for an unusually long period in the operat- 
ing theatre, and may expose them to severe and 
painful amputations — but does this prove that 
he is hard-hearted — and unfaithful or unjust? 
May not all this be essentially necessary for their 
future welfare? If he sees some malignant 
growth on some part of their spiritual frame, 
would he be justified in leaving it there till the 
cancer had preyed upon the vitals, and destroyed 
the hope of ultimate recovery? Would it be real 
kindness to pay more attention to their present 
ease than to their everlasting interests? In all 
He does we may be sure He has an eye to the 
future advantage of His creatures : in effect, He 
says to each of them at such a time, " what I do 
thou knowest not now, but thou shalt know here- 
after.' ' And the conviction of this truth may w T ell 
satisfy our minds of the propriety of His dispen- 
sations, even when we cannot discover the necessity 
for their occurrence. 

Take another instance that illustrates what 
many persons have observed, and that often 
appears unaccountable. When a surgeon is called 
in to examine a deep-seated ulcer, which has 



THE PHYSICIAN. 219 

been rankling in the part for a long time, and 
has resisted a variety of treatment, it is not 
uncommon to find him, as the first step towards 
recovery — not merely probing it to ascertain its 
depth — which of itself often causes a great deal 
of pain — but cutting the edges freely, and enlarg- 
ing it to enable the pent-up matter to escape, 
that the healing process may begin at the very 
bottom, and become solid and enduring. At first 
sight it seems a strange way, to increase a wound 
with a view to its removal, yet both reason and 
experience approve of the proceeding. God 
sometimes acts in a similar way in His providences 
also. Occasionally, when about to visit a poor sin- 
ner with the riches of His grace, we find Him, 
instead of applying a healing salve to the wound 
that His providence has inflicted, and which 
would have only superficially covered over the 
sore, while it might have continued to fester 
underneath, enlarging the wound and keeping it 
open for some time, that it may be more effec- 
tually healed, under His judicious management, 
by a complete and radical cure. Men who do 
not understand the ways of God, or even the 
analogy of nature, are surprised that the first 
steps in a plan of mercy should be a series of 
severe and trying wounds that cut the carnal 
nature in its most tender part, and cause these 



220 THE CONDUCT OF 

sores of our corruption to bleed, and to discharge 
more freely than they did before. 

Sometimes, again, when the patient has the 
premonitory signs of some dangerous disease, such 
as apoplexy or water on the brain, to which 
he has a predisposition, either constitutional or 
acquired, it becomes necessary to insert an issue 
or seton in some part of the system, with the view 
of warding off the threatened danger. The 
remedy, it is needless to say, is irksome, exhaust- 
ing, and severe. It requires, moreover, to be 
continued for a long period to be of any use. But 
then the endurance of it is the means very fre- 
quently of warding off an evil of much greater 
magnitude. How few persons, capable of forming 
a just comparison between the two inconveniences, 
w T ould hesitate as to which they would prefer to 
submit to. And may not many of the trials and 
privations which the Christian is compelled to bear, 
partake more or less of the nature of an issue in 
its present effects, and in its intended benefits. 
Go where he will, he cannot but feel more or 
less acutely, whatever be its nature, that it is 
present with him. He cannot move but it pinches 
him. He cannot shake it off. He cannot forget 
it, or become altogether accustomed to its inconve- 
nience. Yet all the while it may be the means of 
defending him from some other evil of a greater 



the physician. 221 

magnitude. If he is stripped of affluence to 
which he was accustomed, and pinched with want 
or with a restricted income, may it not be to 
guard him against the sin of covetousness, or the 
ensnaring fascinations of the world ? When the 
partner of his bosom is snatched away, and he is 
left to pine in solitary sorrow, during the remain- 
ing years of his appointed pilgrimage, may it not 
be to guard him against the idolatry of the affec- 
tions ? Even the loss of character, the dearest 
of all possessions to a sensitive mind, inflicting, as 
it must do, an irreparable injury upon his peace, 
may yet be made the means of preserving him 
from pride and other dangers of an equally 
hazardous nature. 

The only other point to which we think it ne- 
cessary to allude is the necessity that occasionally 
exists for the removal of a gangrened limb, in 
order to preserve the life of the patient. Were 
not amputation restored to, the spreading of the 
mortification upwards would soon extinguish the 
vital spark. How willing, under such circum- 
stances, are most men to part with a portion of 
their body to secure the remainder. And when 
this has been done, and the operation has proved 
successful, they are necessarily obliged for the 
rest of their lives to put up with many in- 
conveniences to which they were previously 
unaccustomed. Everywhere, and at all times ? 
19* 



222 THE CONDUCT OF THE PHYSICIAN. 

they bear about with them indisputable proofs of 
the deadly malady with which they were attacked, 
and of the trying hour in which their deliverance 
was effected. And does not God often find it 
necessary to amputate our spiritual frames, to cut 
off the putrid affections of a carnal nature, that 
the corroding process may extend no farther, but 
that we may be left, though mutilated, with some 
measure of real life. The blow, whatever its na- 
ture, may have the effect of making us hang 
down our heads like a bulrush, and of keeping us 
humble for the rest of our lives, but if it be the 
means of delivering us from any cherished lust, or 
any improper ambition, if it stimulate us to use 
our remaining talents with a single eye to the 
glory of God, and with greater devotedness to 
His service, we shall have reason to say in this 
respect as in others, it was good for me that I 
was afflicted, for before I was afflicted I w T ent 
astray, but now have I kept thy law. 



CONCLUSION. 223 



CONCLUSION. 

In the statements which have been brought for- 
ward in the foregoing pages, we are far from 
wishing it to be understood that we have by any 
means exhausted the subject, or that all the useful 
purposes that sickness is fitted to accomplish in 
the moral government of the world have been 
pointed out. Many illustrations of the argument 
have been purposely omitted, both because it 
appeared unnecessary to multiply examples of the 
same general principle, and also because the 
instances themselves were thought to be too pro- 
fessional in their details to be acceptable to the 
generality of readers. It is also to be supposed, 
notwithstanding the care that has been taken to 
make the work as complete as possible, that some 
points have escaped notice that a closer and 
more careful examination would have brought to 
light. Be this as it may, we think that sufficient 
has been adduced to establish the position with 
which we started, and to prove that the occur- 
rence of disease is due to the direct appointment 
of God himself. We think it must also be con- 
ceded that such an opinion, far from being repre- 
hensible, as derogatory to the character of the 



224 CONCLUSION. 

Divine Being, is in the highest degree proper to 
be entertained. Let us briefly recapitulate a few 
of the arguments that justify this conclusion. 

In the first place, we have seen that sickness 
is fitted to exercise a beneficial influence on society 
at large, by uniting the scattered members of the 
family of man into one common brotherhood. Is 
not this an object infinitely worthy of the great 
Ruler of the universe ? Ought He not to be sup- 
posed anxious to promote every thing which is 
in the slightest degree calculated to secure the 
prevalence of kind feelings among His creatures, 
and the manifestation of mutual good-will and 
affection towards one another ? The charities of 
life, like delicate flowers, require a congenial soil 
and a favourable climate to germinate in, other- 
wise they will never grow, or blossom, or bear 
fruit. How miserable would be the condition of 
this world, were the seeds that produce such 
blessed plants to lie dormant in the depths of the 
human breast, or to be choked as they spring up, 
by the various forms of selfishness, that, like so 
many weeds which flourish though neglected, 
would prevent it arriving at maturity ! If the 
natural senses can derive enjoyment from the 
beauty and perfume of a few flowers in a well-cul- 
tivated garden, how much more are i\e moral 
perceptions of our nature capable of deriving 
gratification from unobtrusive act& q£ kindness, 



CONCLUSION. 225 

delicately performed towards deserving objects of 
distress ? 

In the second place, we have seen that it is 
equally capable of exercising a beneficial influence 
upon the character of individuals. It impresses 
them, from time to time, with a sense of the 
uncertainty of life, and stimulates them to make 
suitable preparation for the great change that 
awaits them. While fatal diseases tend to pro- 
duce this result, by carrying the conviction of 
human mortality with terrible impressiveness to 
the mind, the slighter forms of indisposition are 
no less calculated to be useful, by the leisure 
they afford for serious reflection during the period 
of convalescence, and by the opportunities of 
amendment that recovery brings with it. We 
have seen that human nature is so constituted as 
to require some suitable counterpoise to the pre- 
ponderating influence that present and passing 
interests possess over those which are less obvious 
to the senses, but which are intrinsically more 
important ; and we have seen that in the circum- 
stances of disease, as it exists in the world, a 
most admirably adapted counterpoise is provided. 
Can we hesitate for a moment to admit that the 
provision in question has proceeded from the 
hand of Him who is intimately cognizant of our 
whole constitution, and who is so deeply interested 
in our welfare ? 



226 CONCLUSION. 

In the third place, we have seen that the very- 
element of suffering — which, at first view, appears 
to be fatal to the idea, that a Being of pure and 
perfect benevolence, such as God is, can be really 
the author of disease, in which it prevails to so 
large an extent — is found, when it comes to be 
closely investigated, to be one of the strongest 
proofs that can be adduced in support of the 
opinion. Contrary to what is generally believed, 
pain performs a most useful part in the progress 
of indisposition. It informs us in a simple and 
striking manner of the actual commencement of 
an attack of illness. It points clearly and empha- 
tically to the precise seat of the disorder. It 
awakens us to a sense of our present danger, and 
puts us on our guard against future mischiefs. 
It stimulates us to employ the proper means for 
our recovery, and it prevents our doing any thing 
that might interfere with the process of cure. It 
is the great means of securing for us all those 
benefits of a moral kind that the whole dispensa- 
tion is intended to accomplish. Is there any 
thing in all this inconsistent with the idea of 
benevolence ? Do we not approve of the con- 
duct of a man who saves a drowning child by a 
vigorous, determined effort, though the firm hold 
he takes of the body may be productive of some 
temporary pain ? And do we not equally con- 
demn the man, were such a person to be found, 



CONCLUSION. 227 

who, in his anxiety to avoid inflicting the slightest 
inconvenience on the child, should hold him so 
loosely as to let him go at the very moment of 
danger, and consign him to a watery grave ? 
Every one will admit that an enlightened spirit 
of humanity would discard at such a time all 
thoughts of the trifling inconvenience of the mo- 
ment, provided the great end of procuring the 
safety of the child were ultimately secured. 
Besides, even the pain that forms so necessary 
and so useful a part of ordinary illness, is not 
suffered to reign paramount throughout the entire 
course of its progress : everywhere there are 
discernible special provisions to mitigate its seve- 
rity and to shorten its continuance, so as to secure 
that it shall neither exceed in amount, nor pre- 
vail for a longer period, than is absolutely neces- 
sary for the purpose it is intended to serve. 

Lastly, we have seen that the phenomena of 
disease are calculated to teach us many useful 
lessons concerning spiritual truth, of which we 
are naturally ignorant, but which it is most impor- 
tant for us to be acquainted with ; while the 
whole history of this part of nature serves as a 
sort of mirror to reflect the features of the Divine 
character, and to exhibit to us His peculiar attri- 
butes and perfections. Can any one, of the least 
candor, hesitate for a moment to acknowledge, 
that a system of Providence which secures so 



228 CONCLUSION. 

many and such various useful ends, must be really 
the result of infinite wisdom and goodness ? 

Assuming, then, that we have succeeded in 
establishing the conclusion at which we wished 
to arrive, it is not difficult to discover what prac- 
tical influence it ought to exert upon every well- 
regulated mind. Most persons are in the habit 
of looking upon a protracted and severe illness as 
a calamity, and exhibit more or less impatience 
during its continuance. The spirit chafes under 
the irritation of a yoke which it is unwilling to 
bear quietly, but which it is unable to shake off. 
They think themselves deserving of a great deal 
of credit if they bear its inconvenience with ordi- 
nary submission, and do not break out into open 
murmurings. Is this the conduct that ought to 
characterize an intelligent creature, duly informed 
of his condition, and thoroughly impressed with 
a conviction of the truth we have been contend- 
ing for ? Would not a right view of the matter 
lead men to regard the visitation of sickness 
rather as a blessing in disguise, which was to be 
received with gratitude and improved with dili- 
gence? Every sick-room may be considered as 
an audience-chamber of the Great King, where 
He condescends to reveal himself to the meanest 
of His creatures. In His presence a solemn 
seriousness should prevail, every murmur should 
be hushed, and the whole attention rivetted in 



CONCLUSION. 229 

humble and eager readiness to listen to His will. 
The dignity of the great Being, who is then 
manifestly near at hand, the importance of the 
occasion, and above all, the gracious purpose of 
the visit, unite in demanding this conduct at our 
hands. If an earthly monarch were at any time 
to lay aside the distance that habitually separates 
him from the ordinary classes of his subjects, and 
were to pay them a familiar visit, for the purpose 
of personally inspecting their affairs, and con- 
ferring on each of them some appropriate benefit, 
would not the condescension of the act, and the 
gracious intention it exhibited, secure for him 
from every one a cordial and enthusiastic wel- 
come ? It is true that the visit itself might be 
productive of much pain to many parties. The 
exposure of some domestic circumstances, and 
the intrusion of so distinguished a visitor at a 
time when they were unprepared to receive him, 
might be any thing but agreeable ; but then 
the motive that so obviously prompted him to 
take such an interest in their welfare, and the 
benefits it produced, would silence every objec- 
tion, and make them deeply thankful that they 
w T ere placed under the dominion of so great and 
good a king. And ought not similar feelings to 
be produced in our minds by an act of gracious 
condescension on the part of God, which infinitely 
surpasses in extent and mercy every instance of 
20 



230 CONCLUSION. 

the kind among earthly sovereigns that it is pos- 
sible to conceive? The true reason of the differ- 
ence of feeling produced in the two cases is our 
ignorance of the character of God, and of the 
principles that regulate His dealings with us. 
Were these better known, not only would there 
be exhibited less dissatisfaction at His provi- 
dential dealings, but the very circumstances which 
now give rise to murmurings and uneasiness, 
would then be the cause of our deepest thankful- 
ness and gratitude. 

It is true, that there are many things in this 
system which we cannot fully comprehend. We 
do not see the why and the wherefore of their 
taking place. It is also true, that there are some 
things which we are apt to suppose, judging by 
the dim twilight of human reason, would be better 
avoided. We are prone to think that God might 
have so ordered matters, had such been His plea- 
sure, as to secure all the benefits that sickness 
is calculated to produce, without any of the suf- 
fering that we see at present attending it. But 
then, it must be recollected, that man is not a 
competent judge to determine such a question. 
The field is too vast for his puny mind to travel 
over : and it becomes him rather to argue analo- 
gically from what he knows to what he does not 
know, and to infer that as every thing is wisely 
and beneficially ordered, so far as he can see, the - 



CONCLUSION. 231 

things which are beyond his comprehension are 
ordered with equal wisdom and beneficence. It 
becomes us also to remember that the difficulties 
which present themselves to our notice in the 
present subject are equally apparent in other por- 
tions of the Creator's works. How many things 
are there in the material world, the uses of which 
we do not understand ? Take the comets for ex- 
ample — those airy travelers in celestial space — 
what purpose in the economy of nature do they 
serve? Conjecture may suggest various replies 
to the question, but candor must compel us to 
acknowledge that we are yet ignorant of their 
real use. How many other things are there in 
nature, with whose use we are acquainted, but 
which appear to us productive of unnecessary 
evil? Such, for instance, are the terrific tempests 
that purify the atmosphere, but whose fury deals 
out death and destruction in their course. May 
we not say with equal justice, that if these things 
be of God, He could have so arranged matters as 
to have given us all the advantages without any 
of the disadvantages. The same remark may be 
made in reference to the dealings of God in the 
kingdom of grace. How much in them is incom- 
prehensible to man? How much appears liable 
to objection? The true answer to all such obser- 
vations is, " shall not the Judge of all the earth 
do right ?" It is impossible for a finite being 



232 CONCLUSION, 

fully to comprehend an infinite : and it is impor- 
tant for us to remember, that much of the difficulty 
of these matters arises from our being at present 
ignorant of many things which are necessary to 
be known before we shall be competent to arrive 
at a just and proper conclusion. 

The attempt to fathom these mysteries, may be 
compared to a man looking into the ocean, whose 
waters may be as clear as crystal throughout their 
entire extent, but which are only transparent at 
the surface : the deeper we try to peer into the 
depths of the abyss, the darker and more indis- 
tinct does our vision become, not from any 
difference in the quality of the water, but simply 
from the circumstance that we happen to occupy 
a position unfavourable for the purpose of seeing 
to the bottom. May we not add, in the language 
of Job, "Lo, these are parts of his ways, but how 
little a portion is heard of him; but the thunder 
of His power who can understand." 



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Cfjoirt unb dlegant jlMtmrjj, 

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PHILADELPHIA. 
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MISS MAY'S FEMALE POETS OF AMERICA; with Biographical and 
Critical Notices, and copious Selections from their Writings. Beauti- 
fully illustrated edition. 12 plates, elegantly bound. 
Also, a 12mo edition, with 2 plates. 
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authors, and arranged under appropriate heads. 
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Rev. H. Hastings Weld. 

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" Containing many gems of thought from writers of the highest ce- 
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A NEW AND IMPORTANT EDUCATIONAL WORK. 



WILLEMENT'S CATECHISM OP FAMILIAR THINGS: 

THEIR HISTORY, AND THE EVENTS WHICH LED TO THEIR 

DISCOVERY; WITH A SHORT EXPLANATION OF 

SOME OF THE PRINCIPAL 

NATURAL PHENOMENA. 

FOR THE USB OF SCHOOLS AND FAMILIES. 

BY EMILY ELIZABETH WILLEMENT. 

CAREFULLY REVISED BY AN AMERICAN TEACHER. 

Extract from the Preface. 
" I wish especially to direct the attention of parents and teachers to the ne- 
cessity of possessing: a work calculated to save them much fatigue in the respon- 
sible office of education. The subjects contained in it may seem in themselves 
unimportant or insignificant. But do not children often ask a variety of ques- 
tions on those very subjects at times when the parent or teacher is not at leisure 
to answer them properly ?— questions on the most simple subjects, asked in 
such a manner as to puzzle the cleverest. Besides, is there one thine: used by 
us in the daily business of life without its historical interest 1 Decidedly not ; 
although, from their commonness, many are passed by as unimportant. I con- 
sider that to trace them to their source is not only amusing-, but highly instruc- 
tive ; for there is scarcely one which is not connected with some epoch import- 
ant in the history of the world." 

OPINIONS OF THE PRESS. 

This very neat little book contains a mass of valuable information, condensed 
in the form of questions and answers, relating to familiar things, about which 
children, and even grown persons, need to be instructed — the history of 
familiar things and the events which led to their discovery, with explanations 
of natural phenomena, &c. &c. For example : there are chapters explanatory 
of Dew, Rain, Atmosphere, Lightning, Twilight, Aurora, &c. <fec. : of the pro- 
ductions of the earth, such as Corn, Barley, Oats, Potatoes, <kc. ; of manufac- 
tures, as Calico, Cloth, Baize, Linen, Stockings, Shoes, Glass. Mirrors, Specta- 
cles, Mariners' Compass, Magnetic Telegraph, &c. &c. : of Metals, Precious 
Stones, Architecture, and kindred arts : Music, Painting, and the Arts and Sci- 
ences generally. It is just such a book as every parent should have to instruct 
his child from, and as could be used in a school with great advantage and plea- 
sure to the pupils. — Traveller. 

This volume comprises a large amount of information in regard to every thing 
that man eats, drinks, breathes, wears, uses for building, for ornament or luxury. 
It is a kind of encyclopedia, defining the name, and often the mode of procuring 
or manufacturing, almost every thing used in common life ; and can readily be 
consulted. — Christian Mirror. 

The varied phenomena of earth and air, fire and water, with most of the im- 
portant elements in uature and art, that constitute the globe a fitting habitation 
for our race, are set forth in this volume, in a condensed, pleasant, and instruc- 
tive form. — Episcopal Recorder. 

A novel and very useful peculiarity of this catechistic compendium is the in- 
sertion of the meaning of the most difficult words or terms occurring in each 
answer at the end of it. The work, without these derivative explanations, is 
copious, accurate, explicit, and well calculated to blend in the youthful mind 
entertainment which shall be impressive, with instruction which shall be per- 
manent.— Hood's Magazine. 



willement's catechism op familiar things. 

Opinions of the Press. 

This is one of the most valuable enelyclopredias for the use of children, wo 
have ever seen. It contains many subjects of great importance to the rising 
generation, and is written in a plain style, divested as far as possible of all tech- 
nicalities, treating:, in a small space, of the various phenomena of nature, the 
general history of the mineral, vegetable, and animal kingdoms, and an outline 
of the arts and sciences. Parents, get it for your children, and by so doing add 
to their knowledge, and save yourselves considerable trouble. — Penn. Telegraph. 

We can very highly recommend this book. It contains a large amount of 
information that immediately concerns every human being. For family reading 
H is especially attractive, and will well repay perusal. It treats of the various 
phenomena of nature, the leading chai act eristics and general history of the ob- 
lects of the animal, vegetable, and mineral kingdoms, and the fundamental 
miths of the arts and sciences. The language of the writer is simple and per- 
spicuous, and will therefore interest juvenile readers.— City Item. 

This is a work of very deep interest, and of great value. The mineral, the 
animal, and the vegetable kingdoms, all pass under review, and are treated m 
a manner to develop and impress the great facts, connected with each, on the 
mind of the student. The arts and sciences also come in for a place, and are 
treated in a similar manner. Children, youth, and families, as a whole, may 
gather much instruction by this book, on the important topics alluded to. — 
Christian Chronicle. 

We have here a great mass of information condensed within very narrow 
limits, touching almost every thing that we have to do with in common life. 
There is hardly any thing connected with our food or raiment, our dwellings, 
our occupations, or our amusements, but what is here very intelligently and 
agreeably discoursed upon, even to the comprehension of a child. If children 
study it well, there is a great chance that they will be wiser in some things 
than their parents.— Puritan Recorder. 

The work is just such an one as we have long thought would be very accept- 
able to the public, and especially to school teachers. It or something as near 
like it as possible should be in every school in the land. — Courier. 

It is designed for use in schools and families, and furnishes a most excellent 
and agreeable method of imparting useful knowledge on all familiar subjects, 
their history, their character, <kc— Bulletin. 

This little work well deserves extensive circulation ; for truly it contains 
"mu:tum in parvo" of such information as is most likely to arrest the attention 
of youthful minds. The style is easy and pleasant, all technical phrases care- 
fully omitted, and the book well adapted to its purpose of providing •' an impor- 
tant auxiliary in the dissemination of useful and entertaining knowledge."— 
Sartains Magazine. 

This book presents a mass of information, in a condensed form, on all kinds 
of things which enter into the every-day concerns of life ; the air we breathe, 
the food we eat, the raiment we are clothed with, the habitations we dwell in, 
the constitution of our mortal frame, arts, commerce and manufactures, are 
cleverly treated of by Question and Answer, and form a mine of useful informa- 
tion. We recommend it to the attention of parents and tutors. — Essex Standard. 

A vast quantity of information is so admirably condensed, and so much really 
useful knowledge is conveyed in so pleasing and intelligible a style, that we can 
honestly award praise We congratulate Mrs. Willement upon having success- 
fully accomplished her task, and heartily recommend her meritorious and un- 
pretending work. — Norfolk Chronicle. 

A useful contribution to the cause of Learning made easy. — Aihenceum. 

A compact and well-printed edition of a most useful book for children ; and 
indeed, a book of reference for all.— Jerrold 's Weekly Newspaper. 

We confidently recommend it to all who are intrusted with the education of 
ildren.— Ipswich Ex-press. 



Jhm Sirtinitnrhs, 

PUBLISHED BY 

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WALKER'S RHYMING DICTIONARY: 

A RHYMING, SPELLING, AND PRONOUNCING DICTIONARY Of 
THE ENGLISH LANGUAGE— In which, 

I. The whole Language is arranged according to its terminations. 

II. Every Word is explained and divided into Syllables exactly as 
pronounced. 

III. Multitudes of Words liable to a double pronunciation are fixed 
in their true sound by a rhyme. 

IV. Many of the most difficult Words are rendered easy to be pro- 
nounced by being classed according to their endings. 

V. Numerous classes of Words are ascertained in their pronunciation, 
by distinguishing them into perfect, nearly perfect, and allowable 
Rhymes. 

To which is prefixed a copious introduction to the various uses of the 
work, with critical and practical observations on Orthography, Syllabi- 
cation, Pronunciation, and Rhyme ; and, for the purpose of Poetry, is 
added an Index of Allowable Rhymes, with authorities for their usage 
from our best Poets. By J. Walker. 1 vol. 12mo. Price, $1 50. 

WATSON'S NEW DICTIONARY OF POETICAL QUOTATIONS, 

Consisting of elegant extracts on every subject, compiled from various 
authors, and arranged under appropriate heads. 10th edition. Price, 
$1 25. .^v™™^. 

WELD'S DICTIONARY OF SCRIPTURAL QUOTATIONS, 
Or Scripture Themes and Thoughts as paraphrased by the Poets. 
Edited by the Rev. H. Hastings Weld. Price, $1 25. 

RAWSON'S DICTIONARY OF SYNONYMES. 
A Dictionary of the Synonymical Terms of tbe English Language, by 
the Rev. James Rawson, D. D. 1 vol. Price, 63 eents. 

JOHNSON'S POCKET DICTIONARY, 
Diamond Edition, with a Portrait and Table of Names of distin- 
guished deceased Americans. 32mo. Cloth. Price, 38 cents. 

do. do. do. Embossed gilt. Price, 50 cents, 

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A NEW AND IMPORTANT EDUCATIONAL WORK. 

WILLEMENT'S CATECHISM OF FAMILIAR THINGS: 

THEIR HISTORY, AND THE EVENTS WHICH LED TO THEIR 

DISCOVERY; WITH A SHORT EXPLANATION OF 

SOME OF THE PRINCIPAL 

NATURAL PHENOMENA. 

FOR THE USE OF SCHOOLS AND FAMILIES. 
BY EMILY ELIZABETH WILLEMENT. 

CAREFULLY REVISED BY AN AMERICAN TEACHER. 



Extract from the Preface. 

"I wish especially to direct the attention of parents and teachers to the ne- 
cessity of possessing: a work calculated to save them much fatigue in the respon- 
sible office of education. The subjects contained in it may seem in themselves 
unimportant or insignificant. But do not children often ask a variety of ques- 
tions on those very subjects at times when the parent or teacher is not" at leisure 
to answer them properly? — questions on the most simple subjects, asked in 
such a manner as to puzzle the cleverest. Besides, is there one thing used by 
us in the daily business of life without its historical interest? Decidedly not; 
although, from their commonness, many are passed by as unimportant. I con- 
sider that to trace them to their source is not only amusing, but highly instruc- 
tive ; for there is scarcely one which is not connected with some epoch import- 
ant in the history of the world." 

OPINIONS OF THE PRESS. 

This very neat little book contains a mass of valuable information, condensed 
in the form of questions and answers, relating to familiar things, about which 
children, and even grown persons, need to be instructed — the history of 
familiar things and the events which led to their discovery, with explanations 
of natural phenomena, &c. &c. For example : there are chapters explanatory 
of Dew, Rain. Atmosphere, Lightning, Twilight, Aurora, &c. &c. : of the pro- 
ductions of the earth, such as Corn, Barley, Oats, Potatoes, &c. ; of manufac- 
tures, as Calico, Cloth, Baize, Linen, Stockings, Shoes, Glass, Mirrors, Specta- 
cles, Mariners' Compass, Magnetic Telegraph, &c. &c. : of Metals, Precious 
Stones, Architecture, and kindred arts : Music, Painting, and the Arts and Sci- 
ences generally. It is just such a book as every parent should have to instruct 
his child from, and as couid be used in a school with great advantage and plea- 
sure to the pupils. — Traveller. 

This volume comprises a large amount of information in regard to everything 
that man eats, drinks, breathes, wears, uses for building, for ornament or luxury. 
It is a kind of encyclopedia, defining the name, and often the mode of procuring 
or manufacturing, almost every thing used in common life ; and can readily be 
consulted.— Christian Mirror. 

The varied phenomena of earth and air, fire and water, with most of the im- 
portant elements in uature and art, that constitute the globe a fitting habitation 
for our race, are set forth in this volume, in a condensed, pleasant, and instruc- 
tive form. — Episcopal Recorder. 

A novel and very useful peculiarity of this catechistic compendium is the in- 
sertion of the meaning of the most difficult words or terms occurring in each 
answer at the end of it. The work, without these derivative explanations, is 
copious, accurate, explicit, and well calculated to blend in the youthful mind 
entertainment which shall be impressive, with instruction which shall be per- 
manent. — Hooa"s Magazine. 



WILLEMEXT S CATECniSM OF FAMILIAR THINGS. 

Opinions of the Press. 

This is one of the most valuable encyclopaedias for the use of children, we 
have ever seen, It contains many sub' importance to the rising 

generation, and is written in a plain style, divested as far as possible of all tech- 
nicalities, treating, m a small space, of the various phenomena of nature, the 
general history of the mineral, vegetable, and animal kingdoms, and an outline 
of the arts and sciences. Parents, get it for your children, and by so doing add 
to their knowledge, and save yourselves considerable trouble.— Perm. Telegraph. 

We can very highly recommend tins book. It contains a large amount of 
information that immediately concerns every human being. For family reading 
it is especially attractive, and will well repay perusal. It treats of the various 
phenomena of nature, the leading chaiuetenstics and general history of the ob- 
jects o( the animal, vegetable, and mineral kingdoms, and the fundamental 
truths of the arts and sciences. The language of the writer is simple and per- 
spicuous, and will therefore interest juvenile readers. — City Item. 

This is a work of very deep interest, and of great value. The mineral, the 
animal, and the vegetable kingdoms, all pass under review, and are treated in 
a manner to develop and impress the great facts, connected with each, on the 
mind oi the student. The arts and sciences also come in for a place, and are 
treated in a similar manner. Children, youth, and families, as a whole, may 
gather much instruction by this book, on the important topics alluded to. — 
Christian Chronicle. 

We have here a great mass of information condensed within very narrow 
limits, touching almost every thing that we have to do with in common life. 
There is hardly any thing connected with our food or raiment, our dwellings, 
our occupations, or our amusements, but what is here very intelligently and 
agreeably discoursed upon, even to the comprehension of a child. If children 
study it well, there is a great chance that they will be wiser in some things 
than their parents.— Puritan Recorder. 

The work is just such an one as we have long thought would be very accept- 
able to the public, and especially to school teachers. It or something as near 
like it as possible should be in every school in the land.— Courier. 

It is designed for use in schools and families, and furnishes a most excellent 
and agreeable method of imparting useful knowledge on all familiar subjects, 
their history, their character, &c— Bulletin. 

This little work well deserves extensive circulation ; for truly it contains 
"mu;tum in parvo" of such information as is most likely to arrest the attention 
of youthful minds. The style is easy and pleasant, all technical phrases care- 
fully omitted, and the book well adapted to its purpose of providing " an impor- 
tant auxiliary in the dissemination of useful and entertaining knowledge." — 
Sartains Magazine. 

This book presents a mass of information, in a condenseJ form, on all kinds 
of things which enter into the every-day concerns of life ; the air we breathe, 
the food we eat, the raiment we are clothed with, the habitations we dwell in, 
the constitution of our mortal frame, arts, Commerce and manufactures, are 
cleverly treated of by Question and Answer, and form a mine of useful informa- 
tion. We recommend it to the attention of parents and tutors. — Essex Standard. 

A vast quantity of information is so admirably condensed, and so much really 
useful knowledge is conveyed in so pleasing and intelligible a style, that we can 
honestly award praise We congratulate Mrs. Willement upon having success- 
fully accomplished her task, and" heartily recommend her meritorious and un- 
pretending work. — Norfolk Chronicle. 

A useful contribution to the cause of Learning made easy.— Athencsum. 
A compact and well-printed edition of a most useful book for children ; and 
indeed, a book of reference for all— J err old's Weekly Newspaper. 

We confidently recommend it to all who are intrusted with the education of 
children. — Ipswich Express. 



